Strengthening District Health Teams Capacity in Surveillance Systems and Response to Public Health Threats in Western Uganda through Field Epidemiology Training Program (FETP): Recent Advances and Development

The goal is to improve the district’s surveillance capacity in order to identify, report, and respond to public health threats more effectively.

Background: A successful surveillance system’s ultimate goal is to improve a health system’s ability by preparing health staff to perform effective surveillance activities. A successful monitoring system is accomplished by making better use of full and timely health data to identify changes in time and respond quickly to reported outbreaks of Public Health events. This evaluation came after the investigator completed a three-month Field Epidemiology Training programme, and he used what he learned to complete the assessment.

From the 15th of December 2019 to the 15th of March 2020, a descriptive cross-sectional, institutional-based epidemiological investigation was performed at the district level and at Health Centre 1V in Kabarole. For epidemiological weeks 44 in 2019 to week 3 in 2020, eReports were retrieved from DHIS-2.

The reporting rates, epidemic disease patterns, and the creation of a malaria channel were all determined using a Microsoft Word Excel programme. Bad HMIS reporting was identified as the leading surveillance quality issue, and a SWOT review was conducted to determine the underlying causes.

Results: For malaria channel building, weekly reports from 53 health facilities and one health centre were analysed. From week 44 in 2019 to week 3 in 2020, the average reporting Timeliness was 32 percent and Completeness was 63 percent among the 53 functional Health facilities assessed in the district. This result indicates that the district did not meet the national goal of 80% Timeliness and 80% Completeness. Because of the inadequate reporting situation, the district may be unable to identify and respond to an emerging Public Health Event in a timely manner. Poor reporting rates were related to a lack of support supervision and a knowledge gap among reporting staff in completing the newly updated HMIS tools. The data showed that the district had a rise in cases of dysentery, measles, and typhoid fever. While the number of cases of dysentery and typhoid fever had reached and exceeded the Warning and Action thresholds, no deaths were confirmed as a result of these illnesses. Following up on the lead, it was discovered that Typhoid fever was being diagnosed using the WIDAL test rather than the WHO-recommended stool or blood culture. Instead of using a blood or stool culture to diagnose typhoid fever, health facilities use the Widal test, which results in theoretical out breaks. The researcher regarded the recorded typhoid fever outbreak in the district as speculative because it was based on incorrect laboratory tests. In Kabarole district, findings on the malaria channel revealed a regular and expected pattern of malaria in 2020.

Conclusion: The investigator was able to determine that the district’s surveillance system was less sensitive in detecting Public Health incidents for a rapid response thanks to the knowledge and skills gained through FETP training. Intensified targeted support oversight and mentorships of all health workers on reporting could aid in the improvement of the district surveillance system.

Author (s) Details

Mathias Tumwebaze
Department of Public Health, Bishop Stuart University, Mbarara, Uganda

Asiimwe Solomon
Kabarole District Local Government, District Health Office Fort Portal Town, Western Uganda

Anna Tukahirwa
Kabarole District Local Government, District Health Office Fort Portal Town, Western Uganda

Saul Kamukama
Makerere University College of Health Sciences, Kampala, Uganda

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