Assessment of integrated disease surveillance and response strategy implementation in selected Local Government Areas of Kaduna state

Abstract

Background: Widespread epidemics of yellow fever and cerebrospinal meningitis across the African sub region in the 1990s were largely attributed to poor surveillance systems which were neither able to detect communicable diseases on time nor mount an effective response. Effective communicable disease control relies on effective response systems which are dependent upon effective disease surveillance. Integrated Disease Surveillance and Response strategy (IDSR) was adopted by the AFRO members of the World Health Organization (WHO) to improve surveillance activities. Aim: This study was conducted to assess IDSR implementation in selected Local Government Areas (LGAs) of Kaduna state. Settings and Design: Kaduna state is located in Northern Nigeria. It shares borders with the states of Sokoto, Katsina, Niger, Kano, Bauchi and Plateau. Based on the 2006 census projections, it has a population of 6.63 million. The study was a cross-sectional descriptive study. Materials and Methods: An interviewer administered questionnaire of an adaptation of the World Health Organization Protocol for the Assessment of National Communicable Disease Surveillance and Response systems was used. Data analysis was carried out using Epi Info statistical package version 3.5.1. Results: About a third of the health facilities (38%) did not have any case definition for the priority diseases. About 76% of the health facilities had electricity available from the National Grid. Seventy one percent have standby generators, out of which 67% were functional. Sixty two percent of health facilities had calculators available for data management while 29% had computers and printers available. No form of data analysis was available in 81% of the health facilities, analysis of data were however available in all 3 LGAs studied. A reporting system was available in 57% of health facilities. Thirteen percent of the health facilities reported receiving feedback from the LGAs. There was no feedback from the state to the LGAs, nor was there feedback from the national to the state level. Conclusion: The implementation of IDSR in Kaduna state is poor. Resources are insufficient and although some structures are present on ground like the presence of reporting mechanism, feedback is poor from the higher to lower levels. Standard case definitions are not used in all health facilities for all priority diseases. Standard case definitions should be made available and used in all health facilities.