Healthcare workers\u2019 experiences regarding scaling up of training on integrated disease surveillance and response (IDSR) in Uganda, 2016: cross sectional qualitative study

Lydia Nakiire,Okot Charles,Francis Adatu,Innocent Komakech,Issa Makumbi,Ben Masiira,Edson Katushabe,Patrick Tusiime,Alemu Wondimagegnehu,Nasan Natseri,Ali Ahmed Yahaya,Miriam Nanyunja,Immaculate Nabukenya,Peter Nsubuga,Solomon Fisseha Woldetsadik,Christine Kihembo,Ibrahima Socé Fall

doi:10.1186/s12913-019-3923-6

Abstract

BackgroundThe Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WHO AFRO). While earlier studies documented gains in performance of core IDSR functions, Uganda still faces challenges due to infectious diseases. IDSR revitalisation programme aimed to improve prevention, early detection, and prompt response to disease outbreaks. However, little is known about health worker’s perception of the revitalised IDSR training.MethodsWe conducted focus group discussions of health workers who were trained between 2015 and 2016. Discussions on benefits, challenges and possible solutions for improvement of IDSR training were recorded, transcribed, translated and coded using grounded theory.ResultsIn total, 22/26 FGDs were conducted. Participants cited improved completeness and timeliness of reporting, case detection and data analysis and better response to disease outbreaks as key achievements after the training. Programme challenges included an inadequate number of trained staff, funding, irregular supervision, high turnover of trained health workers, and lack of key logistics. Suggestions to improve IDSR included pre-service and community training, mentorship, regular supervision and improving funding at the district level.ConclusionHealth workers perceived that scaling up revitalized IDSR training in Uganda improved public health surveillance. However, they acknowledge encountering challenges that hinder their performance after the training. Ministry of Health should have a mentorship plan, integrate IDSR training in pre-service curricula and advocate for funding IDSR activities to address some of the gaps highlighted in this study.

Highlights

The Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WHO World Health Organisation Africa Regional Office (AFRO))
While surveillance was enhanced for all diseases, IDSR focused on outbreak-prone diseases, diseases targeted for elimination or eradication and other diseases or conditions of public health deemed to cause high morbidity and mortality [8]
We considered Focus Group Discussion (FGD) with health workers to be more appropriate for generating information about IDSR training, and suggestions for improvement of training IDSR in Uganda

Summary

Introduction

The Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WHO AFRO). Since the adoption of the IDSR strategy in Uganda in 2000, several interventions were implemented to improve performance These interventions targeted strengthening of IDSR core activities (i.e., case-patient detection, confirmation, reporting, data analysis and interpretation, response, feedback and dissemination) and support functions (i.e., training, communication, coordination, supervision, and resources). These efforts resulted in marked improvements in most IDSR core indicators, including completeness and timeliness of reporting, the proportion of outbreaks investigated within 48 h and reduction in case fatality rates for epidemic diseases such as cholera [9]. Specific objectives included assess benefits, constraints and suggestion for improvement of the training

Methods

Results

Discussion

Conclusion