Challenges of implementing an Integrated Disease Surveillance and Response strategy using the current Health Management Information System in Tanzania

Abstract

Tanzania adopted an Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in order to strengthen its infectious disease surveillance system. During that time, the country had 5 separate surveillance systems to monitor infectious disease trends and disease control programmes. The systems included the Health Management Information System (HMIS); Infectious Disease Week Ending; Tuberculosis/Leprosy; Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome; and Acute Flaccid Paralysis/Poliomyelitis). An assessment of the surveillance systems in the country has shown inadequacy in the use of standard case definitions and laboratory confirmation of cases, supervision and feedback as well as data collection tools. Moreover, in some of the existing vertical disease surveillance programmes, the epidemiological data generated were neither fully analyzed nor utilized at district level, but rather were forwarded to higher levels, which hardly provided any feedback to the lower levels. For these and other reasons, the Ministry of Health adopted the IDSR strategy that will focus on selected priority diseases. Although a significant progress has been made as far as the IDSR strategy is concerned, its implementation is facing several challenges. This is due to the fact that the current surveillance system has to utilize the existing HMIS system in collecting and compiling epidemiological data from health facility and district levels. This paper intends to discuss in detail challenges, which the Ministry of Health and district councils have to take into consideration during the implementation of IDSR strategy. Recommendations are also made for possible adoption to enable smooth running of the IDSR strategy at the national, district and facility levels.

Tanzania Health Research Bulletin Vol.6(2) 2004: 57-63