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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The implementation of Integrated Disease Surveillance and Response in Uganda: A review of progress and challenges between 2001 and 2007
Health Policy and Planning, Volume 28, No. 1, Year 2013
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Description
Background In 2000 Uganda adopted the Integrated Disease Surveillance and Response (IDSR) strategy, which aims to create a co-ordinated approach to the collection, analysis, interpretation, use and dissemination of surveillance data for guiding decision making on public health actions.Methods We used a monitoring framework recommended by World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC)-Atlanta to evaluate performance of the IDSR core indicators at the national level from 2001 to 2007. To determine the performance of IDSR at district and health facility levels over a 5-year period, we compared the evaluation results of a 2004 surveillance survey with findings from a baseline assessment in 2000. We also examined national-level funding for IDSR implementation during 2000-07.Results Our findings show improvements in the performance of IDSR, including: (1) improved reporting at the district level (49% in 2001; 85% in 2007); (2) an increase and then decrease in timeliness of reporting from districts to central level; and (3) an increase in analysed data at the local level (from 10% to 47% analysing at least one target disease, P < 0.01). The case fatality rate (CFR) for two target priority diseases (cholera and meningococcal meningitis) decreased during IDSR implementation (cholera: from 7% to 2%; meningitis: from 16% to 4%), most likely due to improved outbreak response. A comparison before and after implementation showed increased funding for IDSR from government and development partners. However, funding support decreased ten-fold from the government budget of 2000/01 through to 2007/08. Per capita input for disease surveillance activities increased from US$0.0046 in 1996-99 to US$0.0215 in 2000-07.Conclusion Implementation of IDSR was associated with improved surveillance and response efforts. However, decreased budgetary support from the government may be eroding these gains. Renewed efforts from government and other stakeholders are necessary to sustain and expand progress achieved through implementation of IDSR. © 2012 The Author.
Authors & Co-Authors
Lukwago, Luswa
Uganda, Kampala
Uganda Ministry of Health
Uganda, Kampala
Makerere University School of Public Health
Nanyunja, Miriam
Switzerland, Geneva
Organisation Mondiale de la Santé
Ndayimirije, Nestor
Switzerland, Geneva
Organisation Mondiale de la Santé
Wamala, Joseph Francis
Uganda, Kampala
Uganda Ministry of Health
Malimbo, Mugagga
Uganda, Kampala
Uganda Ministry of Health
Mbabazi, William Baguma
Switzerland, Geneva
Organisation Mondiale de la Santé
Gasasira, Anne F.
Uganda, Kampala
Uganda Ministry of Health
Nabukenya, Immaculate N.
Uganda, Kampala
Uganda Ministry of Health
Musenero, Monica M.
Uganda, Kampala
Uganda Ministry of Health
Alemu, Wondimagegnehu
Switzerland, Geneva
Organisation Mondiale de la Santé
Perry, Helen N.
United States, Atlanta
Centers for Disease Control and Prevention
Nsubuga, Peter
United States, Atlanta
Centers for Disease Control and Prevention
Talisuna, Ambrose Otau
Uganda, Kampala
Uganda Ministry of Health
Statistics
Citations: 73
Authors: 13
Affiliations: 4
Identifiers
Doi:
10.1093/heapol/czs022
e-ISSN:
14602237
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Uganda