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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The state of integrated disease surveillance in seven countries: a synthesis report
Public Health, Volume 225, Year 2023
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Description
Objectives: Integrated disease surveillance (IDS) offers the potential for better use of surveillance data to guide responses to public health threats. However, the extent of IDS implementation worldwide is unknown. This study sought to understand how IDS is operationalized, identify implementation challenges and barriers, and identify opportunities for development. Study design: Synthesis of qualitative studies undertaken in seven countries. Methods: Thirty-four focus group discussions and 48 key informant interviews were undertaken in Pakistan, Mozambique, Malawi, Uganda, Sweden, Canada, and England, with data collection led by the respective national public health institutes. Data were thematically analysed using a conceptual framework that covered governance, system and structure, core functions, finance and resourcing requirements. Emerging themes were then synthesised across countries for comparisons. Results: None of the countries studied had fully integrated surveillance systems. Surveillance was often fragmented, and the conceptualization of integration varied. Barriers and facilitators identified included: 1) the need for clarity of purpose to guide integration activities; 2) challenges arising from unclear or shared ownership; 3) incompatibility of existing IT systems and surveillance infrastructure; 4) workforce and skills requirements; 5) legal environment to facilitate data sharing between agencies; and 6) resourcing to drive integration. In countries dependent on external funding, the focus on single diseases limited integration and created parallel systems. Conclusions: A plurality of surveillance systems exists globally with varying levels of maturity. While development of an international framework and standards are urgently needed to guide integration efforts, these must be tailored to country contexts and guided by their overarching purpose. © 2023 The Author(s)
Authors & Co-Authors
Lee, Andrew C.K.
United Kingdom, London
Uk Health Security Agency
Rahman-Shepherd, Afifah
Singapore, Singapore City
National University of Singapore
Erondu, Ngozi A.
Unknown Affiliation
Khan, Mishal Sameer
United Kingdom, London
London School of Hygiene & Tropical Medicine
Pakistan, Karachi
The Aga Khan University
Tegnell, Anders
Sweden, Solna
Public Health Agency of Sweden
Gudo, Eduardo Samo
Mozambique, Chokwe
National Institute of Health
Macicame, Ivalda B.
Mozambique, Chokwe
National Institute of Health
Cuamba, Lutero
Mozambique, Chokwe
National Institute of Health
Ocom, Felix
Uganda, Kampala
Uganda National Institute of Public Health
Ario, Alex Riolexus
Uganda, Kampala
Uganda National Institute of Public Health
Nadon, Celine
Canada, Ottawa
Public Health Agency of Canada
Pyone, Thidar
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 1
Authors: 12
Affiliations: 10
Identifiers
Doi:
10.1016/j.puhe.2023.10.008
ISSN:
00333506
Research Areas
Health System And Policy
Study Design
Grounded Theory
Study Approach
Qualitative
Study Locations
Malawi
Mozambique
Uganda