Abstract
BackgroundDespite advances in medical technology and public health practice at the global level over the past millennia, infectious diseases are still the leading causes of death in most resource limited countries. Stronger infectious disease surveillance and response systems in developed countries facilitated the near elimination of infectious disease related deaths in those countries. Today, low-income countries are following this path by strengthening disease surveillance and response strategies that would help reverse the trend in infectious disease associated morbidity and mortality cases. In 2000, Zambia adopted the World Health Organisation Regional Office for Africa’s (WHO-AFRO) Integrated Disease Surveillance and Response Strategy (IDSR) to monitor, prevent and control priority notifiable infectious diseases in the country. Through this strategy, activities pertaining to disease surveillance are coordinated and streamlined to take advantage of similar surveillance functions, skills, resources and targeted populations. The purpose of the study was to investigate and report on the existing challenges in the implementation of the IDSR strategy in a resource limited country from a health worker perspective.MethodsA qualitative study approach was used to achieve the study aim. Data was collected through key informant interviews with selected persons at the Lusaka Province Health Office (LPHO); Lusaka and Chongwe District Health Management Team Offices; and four selected health facilities in the two districts (two from each). Thematic analysis approach was used to analyse the qualitative data.ResultsThe major successes included operationalised response and epidemic preparedness at all levels (National to district); full-time staff and budget dedicated to disease surveillance at all levels and adoption of the 2010 World Health Organisations’ Integrated Disease Surveillance and Response Strategy technical guidelines to the Zambian context. Several challenges hampered effective implementation. These include inadequate trained human resources, poor infrastructure and coordination challenges.ConclusionThe implementation of IDSR strategy in Zambia has recorded some successes. However, several gaps hinder effective implementation. It is imperative that these gaps are addressed for Zambia to have a robust surveillance system that could inform policy in a comprehensive and timely manner.
Highlights
Despite advances in medical technology and public health practice at the global level over the past millennia, infectious diseases are still the leading causes of death in most resource limited countries
Given the fact that the Integrated Disease Surveillance and Response Strategy (IDSR) strategy is broad as it covers a wide array of activities that are supposed to be effectively implemented to achieve the ultimate goal of timely infectious disease detection and prevention and due to limited time and space, in this study, the researchers purposively selected certain key areas from each of the four components of the IDSR strategy that the researchers felt would to some extent highlight some of the main challenges of implementing the IDSR strategy within the Zambian health system
While the researchers acknowledge the fact that the studied areas of the IDSR strategy in this paper may not be incredibly extensive, it is believed that the findings do highlight some of the prevailing challenges in the implementation of IDSR strategy that are contributing to the high rates of morbidity and mortality cases associated with priority infectious diseases such as Typhoid Fever and Measles in Zambia
Summary
Despite advances in medical technology and public health practice at the global level over the past millennia, infectious diseases are still the leading causes of death in most resource limited countries. Mandyata et al BMC Public Health (2017) 17:746 systems; inability to detect disease outbreaks in a timely manner; duplication of work due to lack of coordination between several single disease control and prevention programmes; overburdened health personnel responsible for disease surveillance in terms of workload and so on [6,7,8,9,10,11] These vertical disease surveillance strategies were failing to cope with the increasing ease of travel of their targeted populace (mostly propagated by air travel), the rapid urbanisation of African cities, and the associated public health challenges that come with them coupled with the incremental threat of emerging and re-emerging diseases of pandemic potential alongside endemic diseases such as Human Immunodeficiency Virus (HIV), Hepatitis and other diseases. The strategy was adopted under resolution AFR/RC48/R2 by the WHO-AFRO member countries in September 1998 when the World Health Organisation Regional Committee for Africa met in Harare, Zimbabwe [12].Some of the aims of the IDSR strategy are to: “train personnel at all levels; develop and carry out plans of action; advocate and mobilise resources; integrate multiple surveillance systems so that forms, personnel and resources can be used more efficiently; improve the use of information to detect changes in time to conduct a rapid response to suspected epidemics and outbreaks; monitor the impact of interventions; facilitate evidence-based response to public health events; and inform health policy design, planning and programme management; improve the flow of surveillance information between and within [various] levels of the health system; strengthen laboratory capacity and involvement in confirmation of pathogens and monitoring of drug sensitivity; emphasise community participation in detection and response to public health problems including event based surveillance and response in line with IHRs [International Health Regulations of 2005]” [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
