Advancing Epidemiological Surveillance through DHIS2 Implementation in the Caribbean: Insights from Antigua and Barbuda, Dominica, Grenada, and St Lucia

This abstract has been accepted at the 2024 DHIS2 Annual Conference

Authors

Gladzdin Jean Denis , Larissa Mark, Michele Francois, Teri Ann Joseph, Osbert Josiah, Shalauddin Ahmed, Ghiselene Paul, Garvin Samuel, Gisele Jean Baptiste, Prabhjot Singh

Introduction:

Aimed at enhancing epidemiological surveillance, the adoption of digital health solutions has emerged as a transformative strategy. Significant strides have been made in leveraging DHIS2 implementation within the Caribbean, especially in Dominica, Antigua and Barbuda, Grenada and St Lucia. Supported by PAHO/WHO, these small island developing states (SIDS) have embarked on a journey to fortify their surveillance systems, bolstering decision-making processes in public health.

Methodology:

Comprehensive needs assessments including that of healthcare infrastructure and resources was conducted in the countries. Tailored modules addressing specific epidemiological challenges were developed or adapted, including for Syndromic Surveillance, COVID-19, vector control and immunization. Pilot initiatives, such as the syndromic surveillance module trial in Antigua and Barbuda, were conducted to refine system efficacy. Training sessions equipped personnel with the requisite skills for DHIS2 configuration and data collection.

Results:

The period spanning March to December 2023 witnessed remarkable progress in DHIS2 implementation. Dominica reported an average completeness rate of 82.4% for submissions by Epidemiological week, underscoring the system‚Äôs operational efficiency with data entry done directly at health centres. Similarly, Antigua and Barbuda achieved a commendable 91% completeness rate although data entry is largely centralized still. The implementation of vector control data collection in Saint Lucia is nearing completion, but significant challenges in Grenada have hampered progress. Staffing shortages especially in the IT area, restricted internet connection through use of VPNs, lack of internet and infrastructure were common challenges. Having a ‚Äėchampion‚Äô was an enabling factor for immunization and syndromic data module uptake in Dominica.

Conclusion:

The collaborative efforts in Antigua and Barbuda, Dominica, Grenada, and St Lucia exemplify the transformative potential of DHIS2 in strengthening epidemiological surveillance within the Caribbean. The SIDS have unique challenges, especially in human resource capacity that can’t be easily overcome and determine the pace of success. Despite these challenges, these nations have embraced information systems for health approach to optimize public health outcomes and mitigate disease burdens effectively, paving the way for more resilient and responsive healthcare systems.

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