The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67530

Stephanie J Posner, MPH PhD¹, Rebecca A. Fields, MPH², Peter K. Mmbuji, MD, MMed³, Lynne M Franco, ScD⁴, Ann B. Jimerson, BA², Leonard Mboera³, and Cara Vileno⁴. (1) PHRplus Project, Tulane University School of Public Health and Tropical Medicine, 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301-718-3192, stephanie_posner@abtassoc.com, (2) CHANGE project, Academy for Educational Development, 1825 Connecticut Ave., NW, Washington, DC 20009, (3) Infectious Disease Surveillance Project, National Institute for Medical Research, P.O. Box 9653, Dar Es Salaam, Tanzania, (4) Partnerships for Health Reform Project, 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814

In developing countries, successful implementation of an Integrated Disease Surveillance and Response system (IDSR) should result in local level health staff being capable and motivated to collect and use surveillance information for public health decisions and actions in both outbreak and routine situations. Prior to defining IDSR implementation strategies in Tanzania, a situation analysis in two districts focused on integrating systems and behavioral characteristics with technical aspects in order to inform the selection of effective implementation strategies. The methodology included a quantitative survey at the district level, in-depth interviews with the district health management teams, district officials, and health workers, and focus group discussions with community leaders and members. The results identified a number of barriers and enabling factors important to effective and sustainable implementation, including normative, motivational, organizational, and participatory issues in addition to knowledge and skills. As a result of these findings, a series of interventions were developed to address 1) the design of the IDSR system, 2) the reduction of contextual and organizational barriers, 3) technical competence related to IDSR at district and facility levels, 4) health personnel motivation and perceived value for IDSR activities, and 5) engagement of appropriate stakeholders for support and involvement in IDSR. As the effects of such factors and their related interventions on IDSR are measured in the future, the development and use of simplified tools for assessing and addressing the key technical, systems, and behavioral factors will be valuable for IDSR strengthening in other developing countries.

Learning Objectives:

At conclusion, participants will be able to:
• Articulate why systems and behavioral factors are important in an assessment of current functioning of an infectious disease surveillance system
• List at lesat 3 key systems and behavioral factors that were integrated into the assessment of IDSR functioning in Tanzania
• Identify interventions that address those factors

Keywords: Surveillance, Infectious Diseases

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.