Makinde Olusesan Ayodeji, Odimegwu Clifford Obby
Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Viable Knowledge Masters, Plot C114 (Platinum Plaza), First Avenue, Gwarinpa, Abuja, Nigeria.
Pan Afr Med J. 2020 Apr 13;35:114. doi: 10.11604/pamj.2020.35.114.21188. eCollection 2020.
Private health facilities are important contributors to health service delivery across several low and middle income countries. In Nigeria, they make up 33% of the health facilities, account for more than 70% of healthcare spending and over 60% of healthcare contacts are estimated to take place within them However, their level of participation in the disease surveillance system has been questioned.
We conducted a cross-sectional survey of 507 private health facilities in South-West Nigeria to investigate the level of compliance with disease surveillance reporting and the factors that affect their participation.
We found only 40% of the private health facilities to be complying with routine disease surveillance reporting which ranged from 17% to 60% across the six states in the region. Thirty-four percent of the private health facilities had the requisite data collection tools, 49% had designated professionals assigned to health records management and only 7% of the clinicians could properly identify the three data collection tools for disease surveillance. Some important factors such as awareness of a law on disease surveillance (OR=1.55 95% CI=1.08-2.24), availability of reporting tools (OR=13.69, 95% CI=8.85-21.62), availability of a designated health records officer (OR=3.9, 95% CI=2.68-5.73), and health records officers (OR=10.51, 95%CI=2.86-67.70) and clinicians (OR=2.49, 95% CI=1.22-5.25) with knowledge of disease surveillance system were important predictive factors to compliance with disease surveillance participation.
Private health facilities are poorly compliant with disease surveillance in Nigeria resulting in missed opportunities for prompt identification and response to threats of infectious disease outbreaks.
在多个低收入和中等收入国家，私立医疗机构是卫生服务提供的重要贡献者。在尼日利亚，它们占卫生机构的33%，占医疗保健支出的70%以上，估计超过60%的医疗接触发生在这些机构中。然而，它们在疾病监测系统中的参与程度受到了质疑。
我们对尼日利亚西南部的507家私立医疗机构进行了横断面调查，以调查疾病监测报告的遵守程度以及影响其参与的因素。
我们发现只有40%的私立医疗机构遵守常规疾病监测报告，该地区六个州的这一比例在17%至60%之间。34%的私立医疗机构拥有必要的数据收集工具，49%有指定的专业人员负责健康记录管理，只有7%的临床医生能够正确识别疾病监测的三种数据收集工具。一些重要因素，如对疾病监测法律的知晓度（OR=1.55，95%CI=1.08-2.24）、报告工具的可用性（OR=13.69，95%CI=8.85-21.62）、指定健康记录官员的可用性（OR=3.9，95%CI=2.68-5.73），以及了解疾病监测系统的健康记录官员（OR=10.51，95%CI=2.86-67.70）和临床医生（OR=2.49，95%CI=1.22-5.25）是遵守疾病监测参与的重要预测因素。
尼日利亚的私立医疗机构在疾病监测方面的遵守情况较差，导致错失及时发现和应对传染病爆发威胁的机会。
