@article{Nuwagaba-Biribonwoha_Nhlabatsi_MacWright_Lokotfwako_Trong_Ryland_Shaikh_Sylvester_McNabb_2017, title={Baseline Assessment of Public Health Surveillance in the Kingdom of Swaziland}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7771}, DOI={10.5210/ojphi.v9i1.7771}, abstractNote={<div style="left: 79.2px; top: 330.667px; font-size: 12.4667px; font-family: sans-serif; transform: scaleX(1.08071);" data-canvas-width="56.124933333333345">Objective</div><div style="left: 92.4px; top: 343.824px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.03891);" data-canvas-width="336.03650666666664">To assess essential support functions for Integrated Disease</div><div style="left: 79.2px; top: 358.491px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00493);" data-canvas-width="346.4499133333334">Surveillance and Response(IDSR) in the Kingdom of Swaziland and</div><div style="left: 79.2px; top: 373.157px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00157);" data-canvas-width="273.8802000000001">make recommendations for a national IDSR Roadmap.</div><div style="left: 79.2px; top: 401.067px; font-size: 12.4667px; font-family: sans-serif; transform: scaleX(1.11702);" data-canvas-width="72.71806666666667">Introduction</div><div style="left: 92.4px; top: 414.224px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.996906);" data-canvas-width="335.07657333333333">Implementation of the IDSR framework for fulfillment of the</div><div style="left: 79.2px; top: 428.891px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.01922);" data-canvas-width="348.9145733333329">International Health Regulations (2005) ([IHR 2005]) has been</div><div style="left: 79.2px; top: 443.557px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.982791);" data-canvas-width="345.9587266666667">challenging in Swaziland due to distribution of IDSR functions across</div><div style="left: 79.2px; top: 458.224px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.960577);" data-canvas-width="347.4085999999999">units within the Strategic Information Department (SID) and other</div><div style="left: 79.2px; top: 472.891px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.01506);" data-canvas-width="346.69301333333334">external departments within the Ministry of Health. We conducted a</div><div style="left: 79.2px; top: 487.557px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.985776);" data-canvas-width="345.92506666666674">qualitative assessment and a Strength, Weaknesses, Opportunities and</div><div style="left: 79.2px; top: 502.224px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.996311);" data-canvas-width="346.11830000000003">Threats (SWOT) analysis of current public health surveillance (PHS)</div><div style="left: 79.2px; top: 516.891px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00138);" data-canvas-width="268.3699333333334">support structures to inform implementation of IDSR.</div><div style="left: 79.2px; top: 544.8px; font-size: 12.4667px; font-family: sans-serif; transform: scaleX(1.07219);" data-canvas-width="51.25046666666667">Methods</div><div style="left: 92.4px; top: 557.957px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.975557);" data-canvas-width="334.73">Key informant interviews, focus group discussions, and a desk</div><div style="left: 79.2px; top: 572.624px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.983917);" data-canvas-width="345.9125999999998">review were performed. Participants were personnel at essential units,</div><div style="left: 79.2px; top: 587.291px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.04219);" data-canvas-width="347.2216000000003">departments and programs at the national level as well as at health</div><div style="left: 79.2px; top: 601.957px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.967882);" data-canvas-width="347.74395333333325">facilities and clinics at regional and local levels. Transcripts were</div><div style="left: 79.2px; top: 616.624px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.997013);" data-canvas-width="346.17938666666663">coded into SWOT matrices using MAXQDA for each building block</div><div style="left: 79.2px; top: 631.291px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.03698);" data-canvas-width="347.4061066666664">of PHS: structures, workforce, resources, processes (detect, report,</div><div style="left: 79.2px; top: 645.957px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.0017);" data-canvas-width="260.3413999999999">assess/analyze, respond, feedback), and informatics.</div><div style="left: 79.2px; top: 673.867px; font-size: 12.4667px; font-family: sans-serif; transform: scaleX(1.08418);" data-canvas-width="45.02960000000001">Results</div><div style="left: 92.4px; top: 687.024px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.01072);" data-canvas-width="335.3894866666669">Selected Strengths included existence of immediate notifiable</div><div style="left: 79.2px; top: 701.691px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00294);" data-canvas-width="346.38259333333326">disease reporting through the Epidemic and Pandemic Response unit</div><div style="left: 79.2px; top: 716.357px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.953688);" data-canvas-width="347.55570666666654">(EPR) and reporting of summary health facility data to the Health</div><div style="left: 79.2px; top: 731.024px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.05226);" data-canvas-width="350.06898666666666">Management Information System (HMIS) unit and laboratory</div><div style="left: 79.2px; top: 745.691px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.995851);" data-canvas-width="346.0085933333334">network. Weaknesses included lack of clear roles and responsibilities</div><div style="left: 79.2px; top: 760.357px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.01262);" data-canvas-width="346.6867800000001">for IDSR among SID units, limited coordination between SID units,</div><div style="left: 79.2px; top: 775.024px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.01286);" data-canvas-width="346.71794666666676">lack of data sharing, lack of Standard Operating Procedures (SOPs),</div><div style="left: 79.2px; top: 789.691px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.988969);" data-canvas-width="347.72151333333335">uncoordinated case investigations and response, minimal analysis</div><div style="left: 79.2px; top: 804.357px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.977488);" data-canvas-width="347.9695999999999">conducted for public health surveillance and limited feedback for</div><div style="left: 79.2px; top: 819.024px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00112);" data-canvas-width="50.539866666666676">reporters..</div><div style="left: 92.4px; top: 833.691px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00995);" data-canvas-width="335.20373333333356">Identified opportunities were political will for establishing of</div><div style="left: 79.2px; top: 848.357px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.0189);" data-canvas-width="348.72009333333335">roles and responsibilities and mechanisms for coordination and</div><div style="left: 79.2px; top: 863.024px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.955497);" data-canvas-width="347.4347799999999">data sharing. Threats were limited data access, limited funding for</div><div style="left: 79.2px; top: 877.691px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00224);" data-canvas-width="311.2303333333332">feedback, lack of analysis for IDSR and paper-based reporting</div><div style="left: 79.2px; top: 905.6px; font-size: 12.4667px; font-family: sans-serif; transform: scaleX(1.1018);" data-canvas-width="74.81246666666668">Conclusions</div><div style="left: 92.4px; top: 918.757px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.978611);" data-canvas-width="334.9294666666669">Currently there is limited use of surveillance data for decision</div><div style="left: 79.2px; top: 933.424px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.963564);" data-canvas-width="347.4933733333334">making due to lack of coordination. Findings were presented at a</div><div style="left: 79.2px; top: 948.091px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.989142);" data-canvas-width="347.7327333333333">dissemination meeting to representatives of relevant departments,</div><div style="left: 79.2px; top: 962.757px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.04887);" data-canvas-width="346.9847333333335">and there was consensus on the need to clearly define the role and</div><div style="left: 79.2px; top: 977.424px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.965671);" data-canvas-width="347.80254666666656">responsibilities of different programs for IDSR. In March 2016, a</div><div style="left: 79.2px; top: 992.091px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.04133);" data-canvas-width="347.3861599999998">consensus meeting was held to designate roles and responsibilities</div><div style="left: 79.2px; top: 1006.76px; font-size: 12.4667px; font-family: serif; transform: scaleX(0.974548);" data-canvas-width="347.7838466666667">for IDSR, a direct result of this assessment. Additional resources</div><div style="left: 79.2px; top: 1021.42px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.00056);" data-canvas-width="346.32649333333336">and funding is needed to support these highly important initiatives to</div><div style="left: 79.2px; top: 1036.09px; font-size: 12.4667px; font-family: serif; transform: scaleX(1.0016);" data-canvas-width="283.90340000000003">ensure the safety and health security of the Swazi nation.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Nuwagaba-Biribonwoha, Harriet and Nhlabatsi, Nhlanhla and MacWright, William and Lokotfwako, Vusie and Trong, Tony A. and Ryland, Paige and Shaikh, Affan and Sylvester, Joy and McNabb, Scott J.}, year={2017}, month={May} }