Background
Methods
Study context
Study design
Data collection tools
Sampling methods
Data collection
Data analysis
Ethical consideration
Results
Characteristics of FGD participants and key informants
Characteristic | Region | Total | |||
---|---|---|---|---|---|
Central | Eastern | Northern | Western | ||
Gender | |||||
Male | 17 | 21 | 25 | 27 | 91 |
Female | 20 | 32 | 36 | 38 | 125 |
Mean age of FGD participants | 38.3 | 40.3 | 39.5 | 38.1 | 38.8 |
Designation of FGD participants | |||||
Nurse | 10 | 32 | 28 | 31 | 101 |
Clinician | 6 | 7 | 8 | 11 | 32 |
Laboratory | 9 | 5 | 12 | 9 | 35 |
Medical Records Officer | 9 | 6 | 7 | 9 | 31 |
Other | 3 | 3 | 6 | 5 | 17 |
Benefits of IDSR training at health facility level
Before we were trained in disease surveillance, many of us never took surveillance to be important. After the training, our attitude towards surveillance completely changed and we are now able to compile and submit all our weekly and monthly reports to the district without fail (FGD participant, Moyo Hospital).
We used to compile our weekly report and physically deliver it to the District Health Officer’s office which is more than 30 km away. This made it very difficult to beat reporting deadlines set by the ministry of health, and sometimes the reports were not delivered. However, ever since mTrac was rolled out in the district, reporting has become much easier since we are now able to submit weekly reports by use of mobile telephones (FGD participant, Kalisizo Hospital).
Theme (aspect of IDSR training) | Key issue |
---|---|
1.0 Benefits of the training | 1.1 Completeness of reporting has improved 1.2 Timeliness of reporting has improved 1.3 Improvement in case detection 1.4 There is better response to outbreaks 1.5 Data analysis has improved |
2.0 Aspects of the training that are not good | 2.1 Few health workers were trained 2.2 The training duration was inadequate 2.3 No follow-up or supervision was done after the training 2.4 No IDSR refresher training was done 2.5 No PPE/IPC materials were supplied |
3.0 IDSR training aspects not practised | 3.1 IDSR supervision and mentorship 3.2 Active case search 3.3 IDSR review meetings or CPDs |
4.0 Recommendations to improve future IDSR training | 4.1 Train more health workers 4.2 Post-training supervision and mentorship 4.3 Increase the duration of the training 4.4 IDSR training should be conducted regularly 4.5 Train community members in IDSR 4.6 Integrating IDSR into pre-service training |
A few months ago, we had a yellow fever outbreak in our district which affected many people. Fortunately, this came at a time when the ministry of health had built our capacity in responding to disease outbreaks. We were able to investigate and respond to this outbreak (….) (FGD participant, Masaka Hospital).
(….) whenever there was an epidemic, Doctors would come from the ministry of health headquarters to handle the situation, but nowadays the district is much involved. We were trained on how to handle disease outbreaks and surveillance (….) (FGD participant, Gulu Hospital).
Negative aspects of IDSR training
(….) we are over forty health workers involved in diagnosis and reporting of health conditions to the district and mTrac yet only about 10 staff were trained in IDSR. Having a large pool of trained health workers enables health facilities to report regularly and consistently (FGD participant, Itojo Hospital).
The training was only conducted for three days, yet the training materials to be delivered to health workers were so many, and this forced the facilitators to rush through sessions without giving us time to appreciate some of the issues (FGD participant, Iganga Hospital).
Aspects taught during IDSR training but are not practised
Due to lack of funds, it is very difficult to practice some of the elements of surveillance emphasised in training such as follow-up of cases, supervision, (….) (FGD participant, Moyo Hospital).
Suggestions to improve future IDSR training
(….) very few people were trained, and many of those that were trained have left. In my opinion, every health worker should have knowledge and skills to implement IDSR at their health facilities, and such skills can be acquired through training or mentorship (FGD participant, Arua Regional Referral Hospital).
Regular supervision and mentorship are a necessity if we are to improve our performance and if the IDSR programme is to have an impact (FGD participant, Kaabong Hospital).
(….) mentorship will ensure that health workers that never had a chance to be trained are empowered with basic knowledge (....) (FGD participant, Pallisa Hospital).
We have several new staff who don’t know much about IDSR and some staff who were trained in surveillance have left (FGD participant, Kaabong Hospital).
The training materials were too many to be delivered in the three days allocated for IDSR training. I suggest that the training duration should be increased from three days to seven days to enable participants to enable a better appreciation of all the materials in the training package (FGD participant, Kamuli Hospital).
The recent IDSR training was conducted more than 5 years after we received the first training. Adults forget fast, and it is important that we have regular training to remind ourselves about surveillance and how to manage outbreaks (....) (FGD participant, Hoima Hospital).
(….) routine training in surveillance will ensure that new health workers are oriented in surveillance (FGD participant, Arua Hospital).
Disease surveillance is part and parcel of our routine work yet during my training as a nurse; we never had any training module on surveillance. I learnt about IDSR after starting work a few years ago. Disease surveillance should be included in training curricula to ensure that all health workers have basic knowledge (….) (FGD participant, Soroti Hospital).
Although it is important to have on-job IDSR training, IDSR should also be emphasised in all institutions that are involved in the training of different cadres of health workers (FGD participant, Kitagata Hospital).