Djibuti Mamuka, Rukhadze Natia, Hotchkiss David R, Eisele Thomas P, Silvestre Eva A
Curatio International Foundation, Tbilisi, Georgia.
Health Policy. 2007 Oct;83(2-3):323-31. doi: 10.1016/j.healthpol.2007.02.009. Epub 2007 Mar 21.
In Georgia, a country where there has been extensive decentralization of public health responsibilities, an intervention was recently piloted to strengthen district-level vaccine-preventable disease (VPD) surveillance and response activities. The purpose of this qualitative research study is to provide an in-depth assessment of the perceived value and need for the analysis and use of VPD surveillance data at various levels of the infectious disease surveillance and response (IDSR) system in Georgia.
Focus groups were conducted with individuals working at different levels of the IDSR system in intervention districts in order to obtain qualitative data to better understand the process of surveillance and barriers to data availability, analysis, and response.
The results of the study suggest that in Georgia, health care system has many barriers to effective analysis and use of VPD surveillance data for decision-making at local level. Extensive decentralization that took place in Georgia may have adversely affected the IDSR system.
In resource poor countries, decentralization can leave districts with insufficient resources, which may seriously affect the ability to carry out IDSR. In Georgia, this seems to be related to inadequate financing of IDSR with major gaps observed at the local level.
在格鲁吉亚这个公共卫生责任已广泛下放的国家，最近试点了一项干预措施，以加强区级疫苗可预防疾病（VPD）监测和应对活动。这项定性研究的目的是深入评估格鲁吉亚传染病监测和应对（IDSR）系统各级对VPD监测数据进行分析和使用的感知价值和需求。
在干预地区对IDSR系统不同层级的工作人员进行焦点小组访谈，以获取定性数据，从而更好地了解监测过程以及数据可得性、分析和应对方面的障碍。
研究结果表明，在格鲁吉亚，医疗保健系统在有效分析和使用VPD监测数据以进行地方层面决策方面存在诸多障碍。格鲁吉亚发生的广泛权力下放可能对IDSR系统产生了不利影响。
在资源匮乏的国家，权力下放可能导致各地区资源不足，这可能严重影响开展IDSR的能力。在格鲁吉亚，这似乎与IDSR资金不足有关，在地方层面存在重大差距。
