Abstract
ObjectiveThe recent 2014 Ebola Virus Disease (EVD) outbreaks rang the bell to call upon global efforts to assist resource-constrained countries to strengthen public health surveillance system for early response. Malawi adopted the Integrated Disease Surveillance and Response (IDSR) strategy to develop its national surveillance system since 2002 and revised its guideline to fulfill the International Health Regulation (IHR) requirements in 2014. This study aimed to understand the state of IDSR implementation and differences between guideline and practice for future disease surveillance system strengthening.MethodsThis was a mixed-method research study. Quantitative data were to analyze completeness and timeliness of surveillance system performance from national District Health Information System 2 (DHIS2) during October 2014 to September 2016. Qualitative data were collected through interviews with 29 frontline health service providers from the selected district and 7 key informants of the IDSR system implementation and administration at district and national levels.FindingsThe current IDSR system showed relatively good completeness (73.1%) but poor timeliness (40.2%) of total expected monthly reports nationwide and zero weekly reports during the study period. Major implementation gaps were lack of weekly report and trainings. The challenges of IDSR implementation revealed through qualitative data included case identification, compiling reports for timely submission and inadequate resources.ConclusionsThe differences between IDSR technical guideline and actual practice were huge. The developing information technology infrastructure in Malawi and emerging mobile health (mHealth) technology can be opportunities for the country to overcome these challenges and improve surveillance system to have better timeliness for the outbreaks and unusual events detection.
Highlights
After the deadly Ebola Viral Disease (EVD) outbreak in Western Africa, governments, health authorities in Africa and the world learnt valuable lessons from the challenges of diseases surveillance systems implementations in countries with limited public health infrastructure [1, 2]
Integrated Diseases Surveillance and Response (IDSR) strategy was adopted in most countries in Africa since 1998, still, challenges of implementing IDSR was evident even before the tragic EVD outbreak in 2014 [10,11,12]
The International Health Regulation (IHR)-2005 enhancement proved to be helpful in dealing with the 2009 H1N1 influenza pandemic and IDSR strategy serves the platform for its implementation in Africa [14, 15]
Summary
After the deadly Ebola Viral Disease (EVD) outbreak in Western Africa, governments, health authorities in Africa and the world learnt valuable lessons from the challenges of diseases surveillance systems implementations in countries with limited public health infrastructure [1, 2]. Integrated Diseases Surveillance and Response (IDSR) strategy was adopted in most countries in Africa since 1998, still, challenges of implementing IDSR was evident even before the tragic EVD outbreak in 2014 [10,11,12]. Shortcomings of the global health system’s capabilities, lack of virological surveillance in Africa and technologies for vaccine production and implementation and the basic public health system infrastructure were exposed during the same pandemic [16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
