A journey towards elimination: Measles surveillance system evaluation – New Juaben Municipality, Eastern Region, Ghana, 2014–2018

Abstract

Background: Measles is one of the vaccine preventable disease. It is a contagious viral disease which causes death among children globally, with majority occurring in Africa despite availability of effective vaccines. Ghana is currently at the elimination stage and therefore surveillance is critical to ensuring that cases are detected early. We evaluated the measles surveillance system at New Juaben Municipality, Eastern Region from 2014–2018 to determine its performance, usefulness and assess its system attributes. Methods and materials: The system was evaluated using the US Center for Disease Control and Prevention updated guidelines 2001. Stakeholders were interviewed using semi-structured questionnaire. Data from 2014 to 2018 from the District's line list and District Health Information Management System 2 was reviewed and analyzed. Qualitative data analysis was done using direct content analysis approach and quantitative data was analyzed descriptively using Microsoft excel 2013. Results presented in graphs and charts. Results: Respondents at all levels had a clear knowledge and understanding of measles, its purpose and objectives of the Surveillance system. The data generated is useful, it is analyzed and used for discussions at meetings. The system had clear simple case definition which made it easy to capture suspected cases. It is integrated into other surveillance system and the introduction of the Rubella vaccine was easily added and adapted which shows its flexibility and during the period under evaluation there has not been any power outages or break downs of computers leading to loss of data which shows the systems stability. The health facilities reported on time to the district, which showed the timeliness and due to adequate reporting it was sensitive enough to detect suspected cases. All stakeholders are involved in the measles surveillance system, they play active role in measles surveillance. It was partially represented as only 22 health facilities out of 26 are reporting with some discrepancies from different data sources. The Predictive Value Positive for 2015; 2.4% and 2016; 3.3%. Conclusion: The system is useful, simple, flexible, stable, and sensitive with low PVP. However data quality needs improvement and Surveillance officers were sensitized on data quality.