George Janeth, Häsler Barbara, Komba Erick V G, Rweyemamu Mark, Kimera Sharadhuli I, Mlangwa James E D
Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania.
SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania.
Front Vet Sci. 2022 Jan 13;8:790035. doi: 10.3389/fvets.2021.790035. eCollection 2021.
A strong animal health surveillance system is an essential determinant of the health of animal and human population. To ensure its functionality and performance, it needs to be evaluated regularly. Therefore, a process evaluation was conducted in this study to assess animal health surveillance processes, mechanisms and the contextual factors which facilitate or hinder uptake, implementation and sustainability of the system in Tanzania. A mixed-method study design was used to evaluate the national animal health surveillance system guided by a framework for process evaluation of complex interventions developed by Moore and others. The system was assessed against standard guidelines and procedures using the following attributes: fidelity, adherence, exposure, satisfaction, participation rate, recruitment and context. Quantitative and qualitative data were collected using a cross-sectional survey, key informant interviews, document review, site visits and non-participant observation. Data from questionnaires were downloaded, cleaned and analyzed in Microsoft™ Excel. Qualitative data were analyzed following deductive thematic and content analysis methods. Fidelity attribute showed that case identification is mainly based on clinical signs due to limited laboratory services for confirmation. Data collection was not well-coordinated and there were multiple disparate reporting channels. Adherence in terms of the proportion of reports submitted per month was only 61% of the target. District-level animal health officials spent an average of 60% of their weekly time on surveillance-related activities, but only 12% of them were satisfied with the surveillance system. Their dissatisfaction was caused by large area coverage with little to no facilitation, poor communication, and lack of a supporting system. The cost of surveillance data was found to be 1.4 times higher than the annual surveillance budget. The timeliness of the system ranged between 0 and 153 days from the observation date (median = 2 days, mean = 6 days). The study pointed out some deviations in animal health surveillance processes from the standard guidelines and their implication on the system's performance. The system could be improved by developing a user-friendly unified reporting system, the active involvement of subnational level animal health officials, optimization of data sources and an increase in the horizon of the financing mechanism.
强大的动物健康监测系统是动物和人类健康的重要决定因素。为确保其功能和性能，需要定期对其进行评估。因此，本研究进行了一次过程评估，以评估坦桑尼亚动物健康监测的过程、机制以及促进或阻碍该系统采用、实施和可持续性的背景因素。采用混合方法研究设计，以摩尔等人制定的复杂干预措施过程评估框架为指导，对国家动物健康监测系统进行评估。根据标准指南和程序，使用以下属性对该系统进行评估：保真度、依从性、暴露率、满意度、参与率、招募情况和背景。通过横断面调查、关键信息访谈、文件审查、实地考察和非参与观察收集定量和定性数据。问卷数据在Microsoft™ Excel中下载、清理和分析。定性数据采用演绎主题和内容分析方法进行分析。保真度属性表明，由于用于确认的实验室服务有限，病例识别主要基于临床症状。数据收集协调不善，存在多个不同的报告渠道。就每月提交报告的比例而言，依从率仅为目标的61%。地区级动物卫生官员平均每周将60%的时间用于与监测相关的活动，但只有12%的人对监测系统感到满意。他们的不满是由于覆盖面积大但几乎没有便利条件、沟通不畅以及缺乏支持系统。发现监测数据的成本比年度监测预算高出1.4倍。该系统的及时性从观察日期起介于0至153天之间（中位数 = 2天，平均数 = 6天）。该研究指出了动物健康监测过程与标准指南之间的一些偏差及其对系统性能的影响。可以通过开发用户友好的统一报告系统、地方一级动物卫生官员的积极参与、优化数据来源以及扩大融资机制范围来改进该系统。
