Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme LFETP) Presentation on Projects 1 and 2 of Basic FETP, Liberia Prepared By: Hilary Zaingbay Cohort 1 Trainee Disease's Surveillance Officer Sanniquellie Mah District Nimba County

Liberia Field Epidemiology Training Programme (LFETP) Acknowledgment I will like to acknowledge – Ministry of Health –AFENET –Emory University –US CDC –WHO –My mentors (Justin and Dr Peter

Liberia Field Epidemiology Training Programme (LFETP) Expanded Weekly Report

Liberia Field Epidemiology Training Programme (LFETP) Summary 4 Out of 18 health facilities: 2 Health Facilities reported on time 16 Health Facilities reported late Expected Epi Report from Wk should be 12 reports per health facility

Liberia Field Epidemiology Training Programme (LFETP) Figure 1.1: Sanniquellie Mah District Timeliness of Reporting, Week 31-42, 2015 HEALTH FACILITY WK 31WK 32WK 33WK 34WK 35WK 36WK 37WK 38WK 39WK 40WK 41WK 42% of Timeliness WK % of Completene ss WK GWHH TTTTLTTTTTTT 92% 100% St. Mary’s TTTTTLTTLTTT 83% 100% YMCA TTTTTTTTTTTT 92% 100% GUMH TTTLLTTTTTTT 92% 100% YekepaHosp TLLTTTTLTTTT 75% 100% Lugbeiyee LTTTTTTTTTTT 100% Duo-Tiayee TTTTTTTTTTTT 100% GCC TTTTLTTTTTTT 92% Newman TTLLTTLTTLLT 67% 100%

Liberia Field Epidemiology Training Programme (LFETP) Figure 1.2: Sanniquellie Mah District Timeliness of Reporting, Week 31-42, 2015 This week On Time T Late L NO REPORT RECEIVED NR % Cumulative >=80% On Time >=50_79.9% ON TIME <50% on time Legend HEALTH FACILITY WK 31WK 32WK 33WK 34WK 35WK 36WK 37WK 38WK 39WK 40WK 41WK 42% of Timeliness WK % of Completeness WK Power House TTTTTTLTTTTT 92% 100% Freepenecostal TTTTLTLTTLTT 83% 100% Bomah TTTTTTTTTTTT 100% Rehab, Hosp TTTTTTTTTTTT 100% 92% Evening Star TTTTTTTTTTTT 92% 100% Agape LTTTTTTTTTTT 92% 83% Zodaumon TTTTTTTTTTTT 100% KL TLTTTTTTTTTT 92% Equip TTTTTTTTTTTT 100%

Liberia Field Epidemiology Training Programme (LFETP) Figure 2: Disease report: Summary of Key Diseases in Week 31-42, Sanniquellie Mah District DiseaseCumulative Epi week CasesDeathCase fatality Rate % Acute watery diarrhea (AWD) 800 Bloody diarrhea 000 Measles 100 Meningitis 000 Human Rabies 000 Neonatal Tetanus 100 Yellow fever 000 Supested EVD 3800 Cholera 000 Lassa fever 000 AFP 000 Maternal Death 100 Neonatal death 100

Liberia Field Epidemiology Training Programme (LFETP) Timeliness and Completeness of Reporting Week 31-42, 2015, Sanniquellie Mah District, Nimba County Percentages Health Facilities

Liberia Field Epidemiology Training Programme (LFETP)

Liberia Field Epidemiology Training Programme LFETP) Project 2 Surveillance Supervision Problem Analysis

Liberia Field Epidemiology Training Programme (LFETP) Surveillance Supervision Problem Analysis INTRODUCTION The Surveillance which is the ongoing collection, analysis and reporting of data is critical to disease spreads prevention if surveillance activities are not supervised well, disease prevention can’t be effective This study is to analyze the problem I have identified in supervision

Liberia Field Epidemiology Training Programme (LFETP) Surveillance Supervision Problem Analysis METHOD Sanniquellie Mah District has a population of 153,931 with eighteen health facilities We analyzed using fish bone and critical cause Fish bone is used to analyze problem on a daily basis worldwide –it consist of cause and effect diagram –Critical cause consists of categorizing problem into three categories: totally within your control to improve (T) partially within your control (P) not in your control (N)

Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme LFETP) The Results

Liberia Field Epidemiology Training Programme (LFETP) LEGEND T - Totally under your control P - Partially under your control N - Not under your control Staff Logistics Surveillance supervision problem High work load((N) under supply(P) In adequate training(p)No maintenance fees(P) Poor communication(P) No communications asset(P) Administration Target Population Lack of supervision(P) gCHVs((T) No support for medical outreach(N) Hard to reach(N) Not understanding supervision(p) Surveillance Focus person(T) OIC TTM(T) Surveillance supervision cause and effect Diagram Poor Communication High workload

Liberia Field Epidemiology Training Programme (LFETP) Recommendations CHT should establish outreach medical team in hard to reach communities in the district DSO should provide case base form CHT to employ health worker to reduce work load CHT to provide VHF-Radio communication in hard to reach health facilities District Health Team to provide training for health facilities staff on surveillance