FETP PROJECT WORK BY DWEADE MUSUE DSO, ST PAUL’S DISTRICT

Introduction Profile of St. Paul District St. Paul is one of the districts of Montserrado County. Boundaries; Bomi County (East), Caresysburg district (west), Todee and Bushrod Island (north), and Atlantic Ocean (South) Mixed ethnic groups: Kpelleh, Gola, Vai and Congo descents. The projected population is 119,832 Project work Expanded surveillance (Epi weeks 31-42) Problem analysis

Expanded Surveillance Report, St Paul’s District, Week 31-42, 2015, Summary 25 reporting facilities One zone No silent facility Total number of case of immediately reportable disease = 76 ( 5 suspected measles, 59 suspected EVD, 9 dysentery, 2 AWD) Total suspected EVD =59, none confirmed, no deaths

Timeliness and Completeness of Surveillance Reporting for High Priority Facilities, St. Paul’s District, Epi Week 31-42, 2015

Cumulative Timeliness of Weekly Surveillance Reporting of High Priority Facilities, St Paul’s District Epi Week 31-42, 2015, Faith community clinic:100% timeliness despite high patient load Action taken: League tables were displayed at the District office. Subsequently, all facilities strive to report timely.

Summary of Notifiable Diseases, St. Paul’s District, EPI Week 31-42, 2015 DiseaseCaseDeath Case Fatality Rate (%) (AFP)000 Measles (suspected)500 NNT000 EVD (suspected)5900 Cholera000 Dysentery900 Lassa Fever000 Yellow Fever000 Meningitis000 Human Rabies000 Other VHF000 AWD200

Trend of EVD Cases And Deaths, St Paul’s District, EPI WEEKS 31-42, 2015 meeting with OICs to improve surveillance sensitization of facility staff about change in case definition of EVD Public Health Action: Samples still being tested from all suspected EVD; None confirmed

Surveillance Quality Problem Analysis Incomplete Reporting on Immediately Reportable Diseases From Health Facilities

Method Identified the problem Formed an inquiry team Brainstormed T,P,N Analysis Critical cause Improvement recommendations

Problem Analysis Team Members District Surveillance Officer: Dweade R. Wilson Zonal Surveillance Officer: Jamesetta Kemokai Officer In Charge:(Kpallah Comm. Clinic):Wislyne Sieh Officer In Charge:(Gbondoi Health Center):Marion Bropleh

STAFF HEALTH FACILITIES ADMINISTRATION LAB FACTORS LOGISTICS Inadequate number of staff (N) Poor attitudes in personne (P)l Over work load (N) Inadequate training in surveillance(p) Inappropriate data capture variables on the forms (P) Inadequate availability of reporting formats (P) Poor network courage(N) Lack base radio in some areas (N) Poor feedback mechanisms from reference laboratory (N) No training in sample collection (P) There are inappropriate supplies (raid kits, swabs, culture medium) for identifying IRD’s.(P) Non functional Labs (lab structure without lab )technicians(N) Lack of graphics, illustrations on facilities walls (P) Lack of surveillance focal person in the health facility (P) Standard case definitions not available to staff in the health facility (P) Lack SOPs on priority diseases (T) No evaluation or feedback on staffs performance (P). Validation of data process is inaccurate from the health facilities (P). Inadequate Training of health facility staff In Surveillance About The Priority Diseases Incomplete reporting on immediately reporting diseases from health facilities

Critical Cause Inadequate Training of Health Facility Staff In Surveillance of the Priority Diseases Other contributory factors Overwork of Staff Poor Attitude of Personnel Inappropriate Data Capture Variables on lab forms Poor Feedback from Reference Laboratory

Recommendations for Improvement DHT: Training of health facility staff on the case definitions of IMRDs Collection and labeling of samples Ensure graphic illustrations are displayed on the walls of Health Facility depicting their monthly activities. MCHT: To evaluate facilities regularly to identify those that are under-staffed and overworked Partners: To re-design surveillance reporting forms to include variables that will self explain the case or event that has happened.

ACKNOWLEDGEMENT FETP family MOH family DHT family CDC, WHO Government of Liberia May God richly bless all of us

THANK YOU