Expanded Surveillance

Report
 Introduction
• Maryland County is located in the Southeastern
region of Liberia
• Has 6 six health districts with 25 health facilities
– 1 Hospital
– 2 health centers
– 22 clinics
• Has three electoral districts
• Population:157,842
Disease Summary 1/2
 Disease Summary 1/2
• Immediately reportable diseases between week 31
• – 42; 1327 cases with 22 deaths.
• – EVD was the highest suspected: 1228 suspected
cases
• • All suspected cases were negative and
reclassified non-cases
• • Zero reporting requirement was met by reporting
• districts
Timeliness and Completeness
Trend of cases and deaths of Acute watery
diarrhoea, Maryland, 2015
Trend of suspected Ebola virus disease cases
and deaths, Maryland, 2015
 Activities during the period under review

• Conducted health assessment to identify gaps

• Recruited and trained DSOs
• Mentored health facilities staff
• Conducted community surveillance meetings
• with TTM’s, gCHV, CHC and CHDC.
 Challenges
• Limited resources
• High Staff attrition rate
• Bad terrines
• Limited communication
 Recommendation
CHT and MOH to supply logistics for surveillance
activities
• MOH to provide HF radios to hard to reach
health facilities
• Proper and adequate training be provided for
all staff in the IDSR to do data analysis, timely
and complete accurate reporting
 Introduction
• A good surveillance system can be assessed by
the quality of data collected.

• A data quality audit was conducted in the

county to identify weaknesses.
 Weaknesses
Main problems:
– Lack of adequate training
– Limited logistics
– Poor regular and supportive supervision
– Lack of communication
– Inconsistence in reporting surveillance data
• Problem analysis:
– INCONSISTENCE IN REPORTING SURVEILLANCE
DATA
Fish bone analysis
 Critical Cause
Poor Supervision
Area lacking supervision Contributing factors

– Data audit – Lack of fuel for supervisors

– Data reporting – Lack of DSA for supervisors
– Response – limited logistics for
– Logistics Management supervisors
– Irregular supply for
– Facility assessment
supervisors
– Lack of budgetary allotment
for surveillance activities in
counties
 Recommendation
• MoH should implement logistics management
• system to ensure logistics are readily available (N)
• • Regular training of staff on data collection and
• analysis (T)
• • Budgetary allotment for surveillance activities in
• counties (N)
• • Periodic data quality audit (T)
 Public health action
We Mentored staff at the health facilities on
data analysis
• explained the importance of every one’s
involvement in the surveillance system during
our regular meetings
• We repaired and replaced 4 HF radios in 4
health facilities
 Acknowledgement
Ministry of Health, Liberia
Field Epidemiology Training Programme, Liberia
Emory University
Centers for Disease Control and Prevention
African Field Epidemiology Network
World Health Organization
My Mentor – Justin and Joseph
Questions