Jaramillo Jahn, Ning Mariangeli Freitas, Cadena Loren, Park Michael, Lo Terrence, Zielinski-Gutierrez Emily, Espinosa-Bode Andres, Reyes Marines, Del Rosario Polo Maria, Henao Olga
Public Health Institute/U.S. Centers for Disease Control and Prevention Global Health Fellowship Program, Oakland, CA, USA.
Division of Global Health Protection, Central America Regional Office, U.S. Centers for Disease Control and Prevention, Guatemala City, Guatemala.
BMC Public Health. 2022 Feb 18;22(1):350. doi: 10.1186/s12889-022-12719-7.
The collaborative integrated surveillance system known as Vigilancia Integrada Comunitaria (ViCo) was implemented in 2007 to better understand and characterize the burden of diarrheal, respiratory and febrile illnesses in Guatemala.
To evaluate the usefulness of ViCo and inform a redesign of the system and new surveillance activities in the Central American region, personnel from the United States Centers for Disease Control and Prevention (CDC) conducted thirty-nine in-depth interviews from June-December 2018 with key stakeholders responsible for the design and implementation of ViCo in Guatemala. A semi-structured questionnaire adapted from the Updated CDC Guidelines for Evaluating Public Health Surveillance Systems was used for data collection. We used a grounded theory approach to explore stakeholder perceptions of ViCo and generate recommendations for improvement. Primary qualitative findings were organized based on thematic areas using ATLAS.ti version 8 software.
Emergent themes relevant to the usefulness of ViCo were organized across strengths, weaknesses, and recommendations pertaining to the: (1) Size and Complexity of ViCo, (2) Stakeholder Expectations About the Objectives of ViCo, (3) Data Management and Structure of the Information System, (4) Local Control of Data, (5) Integration of ViCo within the Ministry of Health, and, (6) Improvement of the Operational and Design Aspects of ViCo across System, Process, and Output levels.
Stakeholders perceived ViCo to be useful. They recommended measures to improve system performance and quality, including simplifying the surveillance system, routine data analysis and feedback, and channeling efforts towards integrating surveillance data into the national health information system. To create a well-performing surveillance system and achieve the intended objective of surveillance for public health action, ongoing evaluation and assessment of surveillance activities are necessary.
2007年实施了名为“社区综合监测系统（ViCo）”的合作综合监测系统，以更好地了解和描述危地马拉腹泻、呼吸道和发热性疾病的负担。
为评估ViCo的实用性，并为中美洲地区该系统的重新设计和新的监测活动提供信息，美国疾病控制与预防中心（CDC）的人员在2018年6月至12月期间，对危地马拉负责ViCo设计和实施的关键利益相关者进行了39次深入访谈。采用了一份根据《疾病预防控制中心公共卫生监测系统评估更新指南》改编的半结构化问卷来收集数据。我们采用扎根理论方法来探究利益相关者对ViCo的看法，并提出改进建议。主要的定性研究结果使用ATLAS.ti 8版本软件，根据主题领域进行整理。
与ViCo实用性相关的新出现主题，按照以下方面的优势、劣势和建议进行组织：（1）ViCo的规模和复杂性；（2）利益相关者对ViCo目标的期望；（3）数据管理和信息系统结构；（4）数据的本地控制；（5）ViCo在卫生部内部的整合；（6）在系统、流程和产出层面改进ViCo的运营和设计方面。
利益相关者认为ViCo是有用的。他们建议采取措施来提高系统性能和质量，包括简化监测系统、进行常规数据分析和反馈，以及努力将监测数据整合到国家卫生信息系统中。为创建一个运行良好的监测系统并实现公共卫生行动监测的预期目标，有必要对监测活动进行持续评估和评价。
