Evaluation of the reinforced integrated disease surveillance and response strategy using short message service data transmission in two southern regions of Madagascar, 2014\u201315

Rado Randriamiarana,Loïc Flachet,Harimahefa Razafimandimby,Rivo Randrianasolo,Grégoire Raminosoa,Nikaria Vonjitsara,Ariane Halm,Arthur Lamina Rakotonjanabelo,Harena Rasamoelina,Richard Lepec

doi:10.1186/s12913-018-3081-2

Rado Randriamiarana, Loïc Flachet + Show 8 more

Open Access

https://doi.org/10.1186/s12913-018-3081-2

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Abstract

BackgroundThe Integrated Disease Surveillance and Response (IDSR) strategy was introduced in Madagascar in 2007. Information was collected by Healthcare structures (HS) on paper forms and transferred to the central level by post or email. Completeness of data reporting was around 20% in 2009–10. From 2011, in two southern regions data were transmitted through short messages service using one telephone provider. We evaluated the system in 2014–15 to determine its performance before changing or expanding it.MethodsWe randomly selected 80 HS and interviewed their representatives face-to-face (42) or by telephone (38). We evaluated knowledge of surveillance activities and selected case definitions, number of SMS with erroneous or missing information among the last ten transferred SMS, proportion of weekly reports received in the last 4 weeks and of the last four health alerts notified within 48 h, as well as mobile phone network coverage.ResultsSixty-four percent of 80 interviewed HS representatives didn’t know their terms of reference, 83% were familiar with the malaria case definition and 32% with that of dengue. Ninety percent (37/41) of visited HS had five or more errors and 47% had missing data in the last ten SMS they transferred. The average time needed for weekly IDSR data compilation was 24 min in the Southern and 47 in the South-eastern region. Of 320 expected SMS 232 (73%) were received, 136 (43%) of them in time. Out of 38 alerts detected, four were notified on time. Nine percent (7/80) of HS had no telephone network with the current provider.ConclusionsSMS transfer has improved IDSR data completeness, but timeliness and data quality remain a problem. Healthcare staff needs training on guidelines and case definitions. From 2016, data are collected and managed electronically to reduce errors and improve the system’s performance.

Highlights

The Integrated Disease Surveillance and Response (IDSR) strategy was introduced in Madagascar in 2007
The Integrated Disease Surveillance and Response (IDSR) approach was proposed to countries in the African region by the Regional Office for Africa of the World Health Organization (WHO AFRO) in 1998
To assess data quality we considered the last ten sent short message service (SMS), for supervision visits and alerts by Healthcare structures (HS) the evaluation period concerned the year 2014, while for routine and alert notification completeness and timeliness we looked at the 4 weeks or four alerts preceding our evaluation interviews respectively

Summary

Introduction

The Integrated Disease Surveillance and Response (IDSR) strategy was introduced in Madagascar in 2007. The Integrated Disease Surveillance and Response (IDSR) approach was proposed to countries in the African region by the Regional Office for Africa of the World Health Organization (WHO AFRO) in 1998. Its purpose is to establish one national communicable disease surveillance system integrating different surveillance activities into one, consisting of functions using the same or similar structures, processes and personnel. The International Health Regulations (IHR) constitute an agreement by WHO member states to IDSR systems can help achieve and sustain countries’ IHR obligations, as priorities like timely detection and response to Public Health (PH) events are shared between the two [6]

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