This abstract has been accepted at the 2024 DHIS2 Annual Conference
Implementing Electronic Integrated Disease Surveillance and Response (IDSR) at Health Facilities in Low and Middle-Income Countries using Mobile Android Devices – a Case Study from Sierra Leone
Prior to the 2014/15 Ebola outbreak, weekly Integrated Disease Surveillance and Response (IDSR) data reporting from health facilities in Sierra Leone was paper based, with completeness and timeliness below 50%. The Ebola outbreak exposed the weaknesses of this system as it proved to be inefficient in achieving its objectives. In 2017, the Ministry of Health (MoH) introduced the electronic IDSR (eIDSR) system running on the DHIS2 platform and began the development of electronic Case Based Disease Surveillance (eCBDS), both allowing the ability to use mobile devices to collect and send surveillance data. To determine the effectiveness of mobile device use in the improvement of the surveillance systems between 2017 and 2023, we analyzed aggregate and case based data extracted from the DHIS2. Data was also collected through document reviews, surveillance technical reports, and epidemiological bulletins. Timelines for the implementation of system development, testing and deployment were analyzed. Timeliness, and completeness indicators were analyzed for the period under review. Mobile device use improved completeness and timeliness of weekly IDSR reports with an average of 97% and 100% respectively from 2017 through 2023. eCBDS data capture improved from 40% in 2019 to 95% in 2023 with numbers equivalent to or surpassing those reported weekly. The eIDSR custom app was developed and rolled out to all health facilities by 2020 including procurement and deployment of tablets with eCBDS benchmarking on the same resources by 2021. Challenges noted include breakdown and or overheating of mobile devices, incompatibility with DHIS2, limited feedback to the health facilities on data that they submit, limited analysis of data by health facility staff. As a result of the challenges identified during mobile devices rollout, the MoH has set minimum specifications for devices as clearly defined in the national digital health roadmap, and the ministry now has a reasonably up to date registry of all government devices. In late 2023, the country introduced analytics on the devices using DHIS2 android app. The use of mobile devices has enhanced electronic IDSR data capture and improved the completeness and timeliness of reporting disease surveillance data from health facilities. Despite the progress made so far in detecting, reporting and responding to disease outbreaks, there are challenges the country needs to address urgently. The government of Sierra Leone needs to build the capacity of health facility staff to effectively analyze and use their own data and secure a dedicated budget by the MOH to
Primary Author: Bridget Magoba
Keywords:
Mobile devices; Android Tablets; DHIS2; DHIS2 Android App; Sierra Leone IDSR; eIDSR; eCBDS.
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