Improving surveillance data quality and use in Tanzania

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Improving surveillance data quality and use in
Tanzania

• Kathryn Kohler Banke, Ph.D.
• Peter Mmbuji, M.D., M.Med.
• Global Health Council
• June 1, 2005

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Overview

• Background integrated disease surveillance and
  response (IDSR)
• PHRplus/National Institute for Medical Research
  (NIMR) project in Tanzania
• Results
• Next steps
• Lessons learned

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Integrated Disease Surveillance and Response
(IDSR)

• WHO strategy for infectious disease surveillance
  in the African region (1998)
• Goal Improved detection of and response to
  priority infectious diseases

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IDSR functions

• Identify cases
• Report
• Analyze and interpret data
• Investigate and confirm cases/outbreaks
• Respond
• Provide feedback
• Evaluate and improve system

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Overview of USAID-funded IDSR strengthening
project in Tanzania

• Partners MOH, National IDSR Task Force, NIMR,
  PHRplus, CDC, CHANGE Project, WHO/AFRO
• Objective Improved prevention and control of 13
  priority infectious diseases
• Implementation 2002-2005
• Develop, test, refine strategies most effective
  for improved system performance in 12 districts
• Focus on district and facility levels

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IDSR priority diseases, Tanzania

• Epidemic-prone diseases
• Cholera, bacillary dysentery, plague, measles,
  yellow fever, cerebrospinal meningitis, rabies
• Diseases targeted for eradication/elimination
• Acute flaccid paralysis, neonatal tetanus
• Diseases of public health importance
• Diarrhea lt5 years, pneumonia lt5 years, malaria,
  typhoid

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Baseline situation Monthly IDSR report accuracy
Accuracy defined as number of cases in submitted
report within /- 5 of number of cases in data
audit.
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Baseline situation Routine data analysis
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The PHRplus/NIMR IDSR intervention in Tanzania (1)

• Situation analysis
• Epidemic preparedness planning
• Disease outbreak management field manual
• Training materials and methods
• Training of trainers district and facility level
  IDSR trainings

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The PHRplus/NIMR IDSR intervention in Tanzania (2)

• Data management, analysis, interpretation tools
• Follow-up visits and district quarterly meetings
• Monitoring and evaluation
• Operational research (costing analysis and
  response)

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The PHRplus/NIMR IDSR intervention in Tanzania (3)

• Laboratory job aids
• Community linkages

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Results IDSR materials and job aids

• Tested, revised, finalized
• Endorsed by IDSR Task Force
• Ready for scale-up

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Results Improved capacity for sustainable
training

• Trained staff at all levels
• 51 District level trainers
• 96 District Health Management Team members
• 32 Facility level trainers
• 787 Facility health workers in 591 facilities
• Strengthened horizontal and vertical linkages
  between National level, Zonal Training Centers,
  Regions, and Districts
• High demand for IDSR training in non-project
  districts

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Results Improved reporting
District Training
Facility Training
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Results Improved reporting
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Results Improved reporting
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Next steps

• Materials methods in place, but funds lacking
• Zonal Training Centers expanding training using
  methods and materials
• Global Fund proposal
• Scale up IDSR plus other health system
  strengthening needs

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Lessons learned

• Understand the system and define standards
• Adapt materials to local context
• Focus on facility and district levels
• Training necessary, but not sufficient
• Integration challenging

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Thank You

• Reports related to this presentation
• are available at www.phrplus.org

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Babati
Dodoma Rural
Project districts
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Results Improved reporting
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Results Improved reporting
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Results Improved reporting
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Results Improved reporting
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