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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. Overview. Background – integrated disease surveillance and response (IDSR)
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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
Overview • Background – integrated disease surveillance and response (IDSR) • PHRplus/National Institute for Medical Research (NIMR) project in Tanzania • Results • Next steps • Lessons learned
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
IDSR functions • Identify cases • Report • Analyze and interpret data • Investigate and confirm cases/outbreaks • Respond • Provide feedback • Evaluate and improve system
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
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 <5 years, pneumonia <5 years, malaria, typhoid
Baseline situation: Monthly IDSR report accuracy Accuracy defined as number of cases in submitted report within +/- 5% of number of cases in data audit.
The PHRplus/NIMRIDSR 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
The PHRplus/NIMRIDSR 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)
The PHRplus/NIMRIDSR intervention in Tanzania (3) • Laboratory job aids • Community linkages
Results: IDSR materials and job aids • Tested, revised, finalized • Endorsed by IDSR Task Force • Ready for scale-up
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
Results: Improved reporting District Training Facility Training
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
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
Thank You Reports related to this presentation are available at www.phrplus.org
Babati Dodoma Rural Project districts