Abstract
BackgroundUganda adopted and has been implementing the Integrated Disease Surveillance (IDSR) strategy since 2000. The goal was to build the country’s capacity to detect, report promptly, and effectively respond to public health emergencies and priorities. The considerable investment into the program startup realised significant IDSR core performance. However, due to un-sustained funding from the mid-2000s onwards, these achievements were undermined. Following the adoption of the revised World Health Organization guidelines on IDSR, the Uganda Ministry of Health (MoH) in collaboration with key partners decided to revitalise IDSR and operationalise the updated IDSR guidelines in 2012.MethodsThrough the review of both published and unpublished national guidelines, reports and other IDSR program records in addition to an interview of key informants, we describe the design and process of IDSR revitalisation in Uganda, 2013–2016. The program aimed to enhance the districts’ capacity to promptly detect, assess and effectively respond to public health emergencies.ResultsThrough a cascaded, targeted skill-development training model, 7785 participants were trained in IDSR between 2015 and 2016. Of these, 5489(71%) were facility-based multi-disciplinary health workers, 1107 (14%) comprised the district rapid response teams and 1188 (15%) constituted the district task forces. This training was complemented by other courses for regional teams in addition to the provision of logistics to support IDSR activities. Centrally, IDSR implementation was coordinated and monitored by the MoH’s national task force (NTF) on epidemics and emergencies. The NTF and in close collaboration with the WHO Country Office, mobilised resources from various partners and development initiatives. At regional and district levels, the technical and political leadership were mobilised and engaged in monitoring and overseeing program implementation.ConclusionThe IDSR re-vitalization in Uganda highlights unique features that can be considered by other countries that would wish to strengthen their IDSR programs. Through a coordinated partner response, the program harnessed resources which primarily were not earmarked for IDSR to strengthen the program nation-wide. Engagement of the local district leadership helped promote ownership, foster accountability and sustainability of the program.
Highlights
Uganda adopted and has been implementing the Integrated Disease Surveillance (IDSR) strategy since 2000
We describe the design and process of IDSR re-vitalisation in Uganda highlighting the roll-out of the revised IDSR guidelines through structured training of the health workforce up to the operational level nation-wide
The health system is structured into national referral hospitals (NRH) at the top, followed by regional referral hospitals (RRHs)
Summary
Uganda adopted and has been implementing the Integrated Disease Surveillance (IDSR) strategy since 2000. All the six IDSR core activities (detection, registration, confirmation, reporting, data analysis and provision of feedback) must operate optimally for prompt public health action [5, 6]. These are enabled by managerial and support functions such as communication, training, supervision, and resource-provision. The strategy, has achieved positive outcomes in countries where IDSR support functions such as training, supervision and resource provision were optimal [14]. The number of IDSR trained personnel was found to be directly proportional to improvements in IDSR core function indicators in several WHO-AFRO states [15]
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