TY - JOUR AU - MacDonald, Pia D. AU - Darcy, Niamh AU - Sembajwe, Rita AU - Reynolds, Eileen AU - Chidawanyika, Henry AU - Kelley, Christopher AU - McKay, Michael AU - Preston, Adam AU - Cressman, Gordon PY - 2017/05/02 Y2 - 2024/03/28 TI - Advancing GHSA: Lessons learned about strengthening HIS and disease surveillance JF - Online Journal of Public Health Informatics JA - OJPHI VL - 9 IS - 1 SE - Surveillance in Low Resource Income Countries DO - 10.5210/ojphi.v9i1.7770 UR - https://ojphi.org/ojs/index.php/ojphi/article/view/7770 SP - AB - <div style="left: 79.8182px; top: 319.945px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08117);" data-canvas-width="56.563006734006734">Objective</div><div style="left: 93.1212px; top: 333.205px; font-size: 12.564px; font-family: serif; transform: scaleX(0.992135);" data-canvas-width="335.42415808080807">The objective is to discuss two decades of international experience</div><div style="left: 79.8182px; top: 347.986px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00378);" data-canvas-width="349.14778585858585">in health information and disease surveillance systems strengthening</div><div style="left: 79.8182px; top: 362.767px; font-size: 12.564px; font-family: serif; transform: scaleX(0.992484);" data-canvas-width="348.70930319865323">and synthesize lessons learned as applicable to implementation of the</div><div style="left: 79.8182px; top: 377.548px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00096);" data-canvas-width="206.91607239057237">Global Health Security Agenda (GHSA).</div><div style="left: 79.8182px; top: 405.676px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.11744);" data-canvas-width="73.28565488215487">Introduction</div><div style="left: 93.1212px; top: 418.935px; font-size: 12.564px; font-family: serif; transform: scaleX(0.985476);" data-canvas-width="337.394189057239">RTI International has worked on enhancing health information</div><div style="left: 79.8182px; top: 433.717px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03855);" data-canvas-width="352.2938047138045">and disease surveillance systems in many countries, including</div><div style="left: 79.8182px; top: 448.498px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03081);" data-canvas-width="349.99459764309773">The Democratic Republic of the Congo (DRC), Guinea, Indonesia,</div><div style="left: 79.8182px; top: 463.279px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04518);" data-canvas-width="352.43577760942725">Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe.</div><div style="left: 79.8182px; top: 478.06px; font-size: 12.564px; font-family: serif; transform: scaleX(0.950953);" data-canvas-width="349.8714707070707">Strengthening these systems is critical for all three of the Prevent,</div><div style="left: 79.8182px; top: 492.841px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00114);" data-canvas-width="351.1994826599325">Detect and Respond domains within the Global Health Security</div><div style="left: 79.8182px; top: 507.622px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00115);" data-canvas-width="42.21494949494949">Agenda.</div><div style="left: 93.1212px; top: 522.403px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00558);" data-canvas-width="335.79730808080814">We have deep experience in this area, ranging from implementing</div><div style="left: 79.8182px; top: 537.185px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00238);" data-canvas-width="351.1994826599326">District Health Information Software (DHIS), electronic medical</div><div style="left: 79.8182px; top: 551.966px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0719);" data-canvas-width="353.1004117845115">records, health facility registries, eHealth national strategies,</div><div style="left: 79.8182px; top: 566.747px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01262);" data-canvas-width="351.5638378787878">electronic Integrated Disease Surveillance and Response system</div><div style="left: 79.8182px; top: 581.528px; font-size: 12.564px; font-family: serif; transform: scaleX(0.982667);" data-canvas-width="348.61758619528604">(eIDSR), mobile real-time malaria surveillance and response, national</div><div style="left: 79.8182px; top: 596.309px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01072);" data-canvas-width="349.4380136363637">weekly disease surveillance, patient referral system, and community</div><div style="left: 79.8182px; top: 611.09px; font-size: 12.564px; font-family: serif; transform: scaleX(0.988542);" data-canvas-width="348.67538047138027">based surveillance. These experiences and lessons learned can inform</div><div style="left: 79.8182px; top: 625.871px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00067);" data-canvas-width="200.63408585858588">work being done to advance the GHSA.</div><div style="left: 93.1212px; top: 640.653px; font-size: 12.564px; font-family: serif; transform: scaleX(0.978586);" data-canvas-width="335.31233872053855">We will discuss several examples, including activities in Zimbabwe</div><div style="left: 79.8182px; top: 655.434px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00468);" data-canvas-width="349.0095821548821">and Tanzania. RTI has been working in Zimbabwe for over six years</div><div style="left: 79.8182px; top: 670.215px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00225);" data-canvas-width="351.23843097643083">to strengthen the national health information system. This work</div><div style="left: 79.8182px; top: 684.996px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0363);" data-canvas-width="349.71567744107733">has included the configuration and roll-out of DHIS 2, the national</div><div style="left: 79.8182px; top: 699.777px; font-size: 12.564px; font-family: serif; transform: scaleX(0.985935);" data-canvas-width="350.64792424242444">electronic health information system. In doing so, RTI examined</div><div style="left: 79.8182px; top: 714.558px; font-size: 12.564px; font-family: serif; transform: scaleX(0.972216);" data-canvas-width="350.0951094276096">and revitalized the weekly disease surveillance system, improving</div><div style="left: 79.8182px; top: 729.339px; font-size: 12.564px; font-family: serif; transform: scaleX(0.976958);" data-canvas-width="350.5976683501682">disease reporting timeliness and completeness from 40% to 90%.</div><div style="left: 79.8182px; top: 744.121px; font-size: 12.564px; font-family: serif; transform: scaleX(0.983028);" data-canvas-width="350.48207979797974">Additionally, RTI has integrated mobile technology to help more</div><div style="left: 79.8182px; top: 758.902px; font-size: 12.564px; font-family: serif; transform: scaleX(0.998181);" data-canvas-width="348.9140959595959">rapidly communicate laboratory test results, a laboratory information</div><div style="left: 79.8182px; top: 773.683px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03974);" data-canvas-width="350.1328013468011">management systems to manage and guide test sample processing,</div><div style="left: 79.8182px; top: 788.464px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03572);" data-canvas-width="349.95188013468">and various other patient level systems in support of health service</div><div style="left: 79.8182px; top: 803.245px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01469);" data-canvas-width="349.45811599326584">delivery at the local level. This work has involved capacity building</div><div style="left: 79.8182px; top: 818.026px; font-size: 12.564px; font-family: serif; transform: scaleX(0.982092);" data-canvas-width="348.626380976431">within the ministry of health to allow for sustainable support of health</div><div style="left: 79.8182px; top: 832.807px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02206);" data-canvas-width="349.8187020202022">information systems practices and technology and improvements to</div><div style="left: 79.8182px; top: 847.589px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00117);" data-canvas-width="185.9844932659933">data dissemination and use practices.</div><div style="left: 93.1212px; top: 862.37px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0227);" data-canvas-width="338.41061447811455">Similarly, RTI has worked for more than five years to help</div><div style="left: 79.8182px; top: 877.151px; font-size: 12.564px; font-family: serif; transform: scaleX(0.9716);" data-canvas-width="350.3426196969698">strengthening the National HIS in Tanzania. These activities have</div><div style="left: 79.8182px; top: 891.932px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03314);" data-canvas-width="351.7686306397306">included stakeholder coordination, developing national eHealth</div><div style="left: 79.8182px; top: 906.713px; font-size: 12.564px; font-family: serif; transform: scaleX(1.09446);" data-canvas-width="354.00376144781126">strategy and enterprise architecture, harmonizing indicators,</div><div style="left: 79.8182px; top: 921.494px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01769);" data-canvas-width="349.7470873737373">redesigning routine reporting instruments, national DHIS 2 roll-out,</div><div style="left: 79.8182px; top: 936.275px; font-size: 12.564px; font-family: serif; transform: scaleX(0.998384);" data-canvas-width="350.79869191919164">information technology infrastructure management and user help</div><div style="left: 79.8182px; top: 951.057px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0292);" data-canvas-width="349.84382996632974">desk support, reducing the number of parallel information systems,</div><div style="left: 79.8182px; top: 965.838px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03383);" data-canvas-width="349.9694696969698">data dissemination and use, development of district health profiles,</div><div style="left: 79.8182px; top: 980.619px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03476);" data-canvas-width="349.73075420875443">development of the national health facility registry, and supporting</div><div style="left: 79.8182px; top: 995.4px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00131);" data-canvas-width="320.31849326599314">roll-out of the electronic integrated disease surveillance system.</div><div style="left: 79.8182px; top: 1023.53px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.0727);" data-canvas-width="51.65049326599326">Methods</div><div style="left: 93.1212px; top: 1036.79px; font-size: 12.564px; font-family: serif; transform: scaleX(0.97063);" data-canvas-width="336.7923747474749">We will profile selected projects and synthesize critical lessons</div><div style="left: 79.8182px; top: 1051.57px; font-size: 12.564px; font-family: serif; transform: scaleX(0.991167);" data-canvas-width="351.18691868686864">learned that pertain to implementation of the GHSA in resource</div><div style="left: 79.8182px; top: 1066.35px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00162);" data-canvas-width="110.26142760942763">constrained countries.</div><div style="left: 452.303px; top: 319.945px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08437);" data-canvas-width="45.38107070707071">Results</div><div style="left: 465.606px; top: 333.205px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01817);" data-canvas-width="338.42317845117816">We will summarize our experience and lessons learned with</div><div style="left: 452.303px; top: 347.986px; font-size: 12.564px; font-family: serif; transform: scaleX(0.972112);" data-canvas-width="350.05741750841736">health information and disease surveillance systems strengthening.</div><div style="left: 452.303px; top: 362.767px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02578);" data-canvas-width="351.8264249158248">Topics such as those that relate to advancing the GHSA Real</div><div style="left: 452.303px; top: 377.548px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01388);" data-canvas-width="351.6128373737373">Time Surveillance and Reporting Action Package areas will be</div><div style="left: 452.303px; top: 392.329px; font-size: 12.564px; font-family: serif; transform: scaleX(0.997981);" data-canvas-width="348.87766043771046">discussed, including: indicator and event based surveillance systems;</div><div style="left: 452.303px; top: 407.11px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01633);" data-canvas-width="349.82247121212083">interoperable, interconnected, electronic real-time reporting system;</div><div style="left: 452.303px; top: 421.892px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04654);" data-canvas-width="352.49231548821547">analysis of surveillance data; syndromic surveillance systems;</div><div style="left: 452.303px; top: 436.673px; font-size: 12.564px; font-family: serif; transform: scaleX(0.997109);" data-canvas-width="348.772123063973">systems for efficient reporting to WHO, FAO and OIE; and reporting</div><div style="left: 452.303px; top: 451.454px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00576);" data-canvas-width="169.94029966329967">network and protocols in country.</div><div style="left: 452.303px; top: 479.581px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.10256);" data-canvas-width="75.39640235690236">Conclusions</div><div style="left: 465.606px; top: 492.841px; font-size: 12.564px; font-family: serif; transform: scaleX(0.981093);" data-canvas-width="337.4142914141413">Our experience working over the past 14 years in 9 countries</div><div style="left: 452.303px; top: 507.622px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02225);" data-canvas-width="351.8917575757577">on different HIS and disease surveillance system strengthening</div><div style="left: 452.303px; top: 522.403px; font-size: 12.564px; font-family: serif; transform: scaleX(0.960915);" data-canvas-width="350.5097205387206">projects has led to a deep understanding of the challenges around</div><div style="left: 452.303px; top: 537.185px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02197);" data-canvas-width="349.8187020202017">implementation of these systems in limited resource settings. These</div><div style="left: 452.303px; top: 551.966px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01154);" data-canvas-width="349.4380136363636">experiences and lessons learned can inform initiatives and programs</div><div style="left: 452.303px; top: 566.747px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00074);" data-canvas-width="113.0506296296296">to advance the GHSA.</div> ER -