Abstract
IntroductionPrivate health facilities are important contributors to health service delivery across several low and middle income countries. In Nigeria, they make up 33% of the health facilities, account for more than 70% of healthcare spending and over 60% of healthcare contacts are estimated to take place within them However, their level of participation in the disease surveillance system has been questioned.MethodsWe conducted a cross-sectional survey of 507 private health facilities in South-West Nigeria to investigate the level of compliance with disease surveillance reporting and the factors that affect their participation.ResultsWe found only 40% of the private health facilities to be complying with routine disease surveillance reporting which ranged from 17% to 60% across the six states in the region. Thirty-four percent of the private health facilities had the requisite data collection tools, 49% had designated professionals assigned to health records management and only 7% of the clinicians could properly identify the three data collection tools for disease surveillance. Some important factors such as awareness of a law on disease surveillance (OR=1.55 95% CI=1.08-2.24), availability of reporting tools (OR=13.69, 95% CI=8.85-21.62), availability of a designated health records officer (OR=3.9, 95% CI=2.68-5.73), and health records officers (OR=10.51, 95%CI=2.86-67.70) and clinicians (OR=2.49, 95% CI=1.22-5.25) with knowledge of disease surveillance system were important predictive factors to compliance with disease surveillance participation.ConclusionPrivate health facilities are poorly compliant with disease surveillance in Nigeria resulting in missed opportunities for prompt identification and response to threats of infectious disease outbreaks.
Highlights
Infectious disease outbreaks arising from highly pathogenic organisms with a propensity to spread across national borders are happening more frequently
Of these 248 assigned health records officers, barely 13 (5%) could properly identify the three data collection tools used for disease surveillance in Nigeria
Some mentioned absolutely the data collection tools of the National Health Management Information System (NHMIS) which is managed as an independent data collection system from the disease surveillance system signifying some confusion
Summary
Infectious disease outbreaks arising from highly pathogenic organisms with a propensity to spread across national borders are happening more frequently. In Nigeria, they make up 33% of the health facilities, account for 70-80% of healthcare spending and over 60% of healthcare contacts are estimated to take place within them [14,15,16] Their importance in healthcare delivery has been on an upward drive arising from the incessant industrial action embarked upon by public sector workers and the perceived poor quality of service provided by public health facilities in the country [17,18]. Secondary health facilities in the country which cater to a significant burden of diseases are predominantly privately owned [20] Despite their importance in health service delivery in Nigeria, the level of participation of private health facilities in the disease surveillance system has been questioned [21]. This study provides knowledge that is important in determining the level of compliance and the factors that affect the participation in the disease surveillance system in Nigeria, important information in addressing the shortcomings
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