Epidemiology and Surveillance Division, Ministry of Health, P.O BOX 7072, Kampala, Uganda.
Public Health Emergency Operations Centre, Ministry of Health, P.O BOX 7072, Kampala, Uganda.
BMC Public Health. 2018 Jul 13;18(1):879. doi: 10.1186/s12889-018-5755-4.
Uganda adopted and has been implementing the Integrated Disease Surveillance (IDSR) strategy since 2000. The goal was to build the country's capacity to detect, report promptly, and effectively respond to public health emergencies and priorities. The considerable investment into the program startup realised significant IDSR core performance. However, due to un-sustained funding from the mid-2000s onwards, these achievements were undermined. Following the adoption of the revised World Health Organization guidelines on IDSR, the Uganda Ministry of Health (MoH) in collaboration with key partners decided to revitalise IDSR and operationalise the updated IDSR guidelines in 2012.
Through the review of both published and unpublished national guidelines, reports and other IDSR program records in addition to an interview of key informants, we describe the design and process of IDSR revitalisation in Uganda, 2013-2016. The program aimed to enhance the districts' capacity to promptly detect, assess and effectively respond to public health emergencies.
Through a cascaded, targeted skill-development training model, 7785 participants were trained in IDSR between 2015 and 2016. Of these, 5489(71%) were facility-based multi-disciplinary health workers, 1107 (14%) comprised the district rapid response teams and 1188 (15%) constituted the district task forces. This training was complemented by other courses for regional teams in addition to the provision of logistics to support IDSR activities. Centrally, IDSR implementation was coordinated and monitored by the MoH's national task force (NTF) on epidemics and emergencies. The NTF and in close collaboration with the WHO Country Office, mobilised resources from various partners and development initiatives. At regional and district levels, the technical and political leadership were mobilised and engaged in monitoring and overseeing program implementation.
The IDSR re-vitalization in Uganda highlights unique features that can be considered by other countries that would wish to strengthen their IDSR programs. Through a coordinated partner response, the program harnessed resources which primarily were not earmarked for IDSR to strengthen the program nation-wide. Engagement of the local district leadership helped promote ownership, foster accountability and sustainability of the program.
乌干达自 2000 年以来采用并一直在实施综合疾病监测（IDSR）战略。其目标是建立国家发现、迅速报告和有效应对突发公共卫生事件和重点疾病的能力。该方案启动时得到了大量投资，取得了相当大的 IDSR 核心绩效。然而，由于 2000 年代中期以后资金无法持续，这些成果受到了破坏。在世界卫生组织（WHO）修订的 IDSR 指导方针通过后，乌干达卫生部（MoH）与主要合作伙伴合作，决定于 2012 年重振 IDSR 并实施最新的 IDSR 指导方针。
通过审查已发表和未发表的国家指南、报告和其他 IDSR 方案记录，以及对关键信息提供者的访谈，我们描述了 2013-2016 年乌干达重振 IDSR 的设计和过程。该方案旨在增强地区迅速发现、评估和有效应对突发公共卫生事件的能力。
通过分层、有针对性的技能发展培训模式，2015 年至 2016 年间共有 7785 人接受了 IDSR 培训。其中，5489 人（71%）为医疗机构多学科卫生工作者，1107 人（14%）为地区快速反应小组，1188 人（15%）为地区工作队。除了提供后勤支持 IDSR 活动外，该培训还为区域团队提供了其他课程。中央一级，卫生部国家流行病和紧急情况工作队（NTF）协调和监测 IDSR 的实施。NTF 与世界卫生组织国家办事处密切合作，从各伙伴和发展倡议调动资源。在区域和地区一级，调动了技术和政治领导力量，参与监测和监督方案实施。
乌干达的 IDSR 重振突出了其他国家可以考虑的独特特征，这些国家希望加强本国的 IDSR 方案。通过协调的伙伴应对，该方案利用了原本并非专门用于 IDSR 的资源，在全国范围内加强了该方案。地区领导的参与有助于促进方案的所有权、问责制和可持续性。
