Epidemiological Surveillance Program, Ministry of Public Health, Beirut, Lebanon.
Clinical Trial Program, Ministry of Public Health, Beirut, Lebanon.
BMC Health Serv Res. 2022 Mar 25;22(1):395. doi: 10.1186/s12913-022-07773-1.
The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response.
This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities.
This is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons who were working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. The unveiled challenges and the main lessons learned during the roll-out process were discussed.
For laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25 to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74 to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity, limited workforce, and frequent changes to DHIS-2 versions.
Implementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2.
黎巴嫩公共卫生部正在将监测报告从繁琐的纸质系统转换为基于网络的电子平台（DHIS-2），以便实时获取信息，及时发现警报和疫情，并迅速做出反应。
本文旨在记录黎巴嫩在实施 DHIS-2 用于疾病监测系统方面的经验。它还旨在评估报告率和报告数据及时性的提高，并揭示所遇到的挑战和机遇。
这是对黎巴嫩实施 DHIS-2 工具的过程进行的回顾性描述。最初，它于 2014 年在基于学校的监测中进行了试点；然后，于 2017 年 5 月将其使用范围扩大到其他特定监测系统。这包括从医院、医疗中心、诊所或实验室收集汇总数据的所有监测计划在第一阶段。作为国家推广过程的一部分，开发了在线应用程序。生成了定制的基于汇总的数据集、组织单位、用户账户、特定和通用仪表板。在全国各地举办了 80 多场培训课程，共有 1290 名最终用户参加，包括国家和省级卫生官员、在所有公立和私立医院、实验室和医疗中心工作的联络人。比较了实施 DHIS-2 前后报告数据的完整性和及时性。讨论了在推广过程中发现的挑战和主要经验教训。
对于基于实验室的监测，报告的完整性从 5 月的 70.8%提高到 10 月的 89.6%。及时性从 25%提高到 74%。对于医疗中心，培训前后的完整性提高了 8.1%，及时性提高了 9.4%。零报告的完整性保持不变（88%），及时性从 74%提高到 87%。在实施 DHIS-2 过程中面临的主要挑战主要是基础设施和系统相关的，此外还有互联网连接不良、劳动力有限以及 DHIS-2 版本频繁更改。
实施 DHIS-2 提高了汇总数据报告的及时性和完整性。需要持续的现场支持、监测和系统增强，以提高 DHIS-2 的性能。
