Abstract
IntroductionKenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County.MethodsHealth facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting.ResultsFrom September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20).ConclusionThe majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person.
Highlights
Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response
IDSR technical guidelines were found in 11(6.3%) facilities while 116(66.3%) facilities had some evidence of data analysis through displayed trend graphs
These factors included a facility having the weekly reporting forms as compared to those that did not have the forms (Adjusted OR [AOR] 19, 95% confidence intervals (CI): 6-65), a facility having a designated surveillance focal person as compared to those without a designated focal person (AOR7, 95% CI: 2-20) and availability of posters with IDSR functions in the facility as compared to facilities that did not have these IDSR posters (AOR8, 95% CI: 212) (Table 3). This cross sectional survey looking at surveillance performance showed that adequate weekly reporting to IDSR system in Nairobi County was low and below the target of 80% given in the World Health Organization (WHO) IDSR guidelines. To further explain these findings, we found three factors that were independently associated with promoting adequate reporting in Nairobi County: a facility having weekly reporting forms, a facility with a dedicated surveillance focal person and a facility with posters of IDSR functions displayed
Summary
Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. We conducted a crosssectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). Conclusion: The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person. Poor disease surveillance has been identified as one of the major factors responsible for increasing mortality and morbidity due to communicable diseases [4,5]. The recent outbreak of Ebola Viral Disease in West Africa has demonstrated the importance of an effective national surveillance and response system [9]
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