The integrated disease surveillance and response system in northern Ghana: challenges to the core and support functions.

Martin N Adokiya,Claudia Beiersmann,Olaf Müller,John K Awoonor-Williams

doi:10.1186/s12913-015-0960-7

Abstract

BackgroundThe integrated disease surveillance and response (IDSR) strategy was adopted in Ghana over a decade ago, yet gaps still remain in its proper functioning. The objective of this study was to assess the core and support functions of the IDSR system at the periphery level of the health system in northern Ghana.MethodsA qualitative study has been conducted among 18 key informants in two districts of Upper East Region. The respondents were from 9 health facilities considered representative of the health system (public, private and mission). A semi-structured questionnaire with focus on core and support functions (e.g. case detection, confirmation, reporting, analysis, investigation, response, training, supervision and resources) of the IDSR system was administered to the respondents. The responses were recorded according to specific themes.ResultsThe majority (7/9) of health facilities had designated disease surveillance officers. Some informants were of the opinion that the core and support functions of the IDSR system had improved over time. In particular, mobile phone reporting was mentioned to have made IDSR report submission easier. However, none of the health facilities had copies of the IDSR Technical Guidelines for standard case definitions, laboratories were ill-equipped, supervision was largely absent and feedback occurred rather irregular. Informants also reported, that the community perceived diagnostic testing at the health facilities to be unreliable (e.g. tuberculosis, Human Immunodeficiency Virus). In addition, disease surveillance activities were of low priority for nurses, doctors, administrators and laboratory workers.ConclusionsAlthough the IDSR system was associated with some benefits to the system such as reporting and accessibility of surveillance reports, there remain major challenges to the functioning and the quality of IDSR in Ghana. Disease surveillance needs to be much strengthened in West Africa to cope with outbreaks such as the recent Ebola epidemic.

Highlights

The integrated disease surveillance and response (IDSR) strategy was adopted in Ghana over a decade ago, yet gaps still remain in its proper functioning
The Integrated Disease Surveillance and Response (IDSR) strategy focuses on the district level of the health systems [13]
Over half (10/18) of the informants indicated that they were working at the same health facility for the past four or more years while 6/18 were working at this place for a period of one to three years and the remaining 2/18 less than a year

Summary

Introduction

The integrated disease surveillance and response (IDSR) strategy was adopted in Ghana over a decade ago, yet gaps still remain in its proper functioning. The World Health Organization Regional Office for Africa (WHO-AFRO) and other partners were asked by the various ministries of health to develop strategies that would enable countries to respond adequately to these challenges including detection and confirmation of diseases in time and overall strengthening of surveillance capacities [4]. In 1998, WHO-AFRO adopted the Integrated Disease Surveillance and Response (IDSR) strategy for its member countries as a comprehensive public health strategy [5, 8,9,10,11]. The goal of the IDSR strategy is to build member countries capacity to detect, report and effectively respond to priority diseases as well as to integrate multiple existing vertical surveillance systems, and linking laboratory and other data sources for public health action [9, 12,13,14]. The IDSR strategy focuses on the district level of the health systems [13]

Objectives

Methods

Results

Conclusion