The Implementation of Integrated Disease Surveillance and Response Strategy by DSNOs in Priority Health Facilities in Lagos and Oyo States

Abstract

Surveillance and response activities are key to the prevention and control of emerging and reemerging diseases in sub-Saharan Africa. In Nigeria, Lagos and Oyo States have recently recorded several cases of disease outbreaks despite funding and capacity building for an effective IDSR system. Some of
the challenges observed include poor knowledge, lack of material resources, lack of supportive supervision including poor feedback mechanisms. Hence the call for a robust public health surveillance system with the right human and material resources providing the necessary and adequate information for
public health action. This study aimed to assess and compare the implementation of the IDSR strategy by DSNOs in priority health facilities in Lagos and Oyo States. This was a comparative cross-sectional study th th on IDSR carried out from 25 February to 9 April 2021 among DSNOs working in the priority health facilities in Lagos and Oyo States. A multi-stage sampling technique was used to select a sample of 216 healthcare workers from priority health facilities in Lagos and Oyo states. Interviewer-administered questionnaires were used to collect data and it was analyzed using IBM Statistical Product and Service Solutions version 26 (SPSS Inc., Chicago, IL, USA); values of p < 0.05 were considered statistically significant. Respondents from priority health facilities in Lagos and Oyo states comprised 110 (50.9%) and 106 (49.1%), respectively. There was a statistically significant difference between the mean age and SD were 39.1±8.6 years for Lagos State and 41.2 ± 7.9 years for Oyo State (p=0.050). There was female preponderance (80.9% and 80.2%) in  similar proportions in Lagos and Oyo States respectively. The majority (80.9%) of respondents in Lagos State had overall good knowledge of IDSR strategy  compared to Oyo state with 64.2% and this was statistically significant (p=0.006*). Majority in Lagos State compared to Oyo State reported that  they carried out timely and complete submission of reports weekly (63.6% and 61.3%) and monthly (71.8% and 65.1%) to the LGA in the last 6 months.  Also, 50.9% of the respondents in Oyo State compared to 44.5% in Lagos State said they performed trend analysis of the health facility report of notifiable  diseases in the last 6 months. The majority (71.8% and 76.4%) of the respondents in Lagos State compared to Oyo State said they used  telephone/GSM for disease reporting and there was a statistically significant association between respondents who used car/bus for disease reporting on  IDSR activities and the methods of disease reporting in Lagos and Oyo States, (p<0.001*). Some of the challenges of IDSR strategy at priority health  facilities in Lagos State compared with Oyo state include lack of training on IDSR (53.6% vs 40.6%); lack of means of transportation for IDSR activities  (57.3% vs 47.2%); inadequate supply of forms for disease notification and reporting (47.3% vs 27.4%) and weak supervision of the health facility DSNOs by  the LGA DSNOs on disease reporting activities (31.8% vs 27.4%).The findings from this study revealed that although there was good level of knowledge  in both states, the implementation of IDSR in Lagos and Oyo states was poor as the core performance indicators remained below 100% of the  expected for facilities that carried out trend analysis. Also, the core performance indicators were 80% for those that submitted weekly (or monthly)  surveillance reports on time to the next higher level. It is recommended that the frequency of supportive supervision by the state and FMoH should be  increased to strengthen the IDSR system in both states.