1. Project work Report Maima D. Kiatamba District Surveillance Officer, Bushrod District, Monrovia, Liberia November 2, 2015

2. Introduction Background to Bushrod District – total population of 287493 – 48 health facilities FETP Project work – Weekly surveillance reporting – Expanded surveillance report (Weeks 31-42) – Problem analysis

3. Expanded Surveillance Report, Epi Weeks 31 to 42, 2015, Bushrod District

4. Summary Immediately reportable diseases; – 22 suspected EVD, 10 suspected Measles and 9 suspected cholera – None confirmed – No deaths 3 silent facilities

5. Reporting quality Completeness & Timeliness of weekly zonal reporting in Bushrod District for Epi Weeks 31-42 2015

6. Most of the late reports / NR were in wks 31-35 Logistics issues Poor attitude Hard to reach areas (zone 1600) Public Health Action Regular sensitization of OICs on surveillance

7. Summary of Key Notifiable diseases Epi week 31-42, Bushrod District 2015

8. Comments/actions taken No samples were taken to the lab All were treated and discharged (no death)

9. Comments/Actions taken At the beginning, figures were low until during supervision we observed that the cases were being under-reported No positive EVD result was received Follow-up on pending results No deaths of live suspected cases reported

10. PROBLEM ANALYSIS

11. Surveillance quality problem: Inadequate Laboratory Support for Surveillance Activities in Bushrod District

12. Method 1.Team formation: 2.Team field/assessment visit: 3.Brainsorming/working sessions: 4.Final report/presentation development:

13. Problem Analysis Team Members Maima D. Kiatamba-District Surveillance Officer William S. Sawyer-District Health Officer HF-Doressa Bestman-Zonal Surveillance Officer Winifred Y. Hallowwanger-Lab Supervisor Redemption Hospital Mohammed A Bah-Lab Assistant Supervisor Slipway Clinic Samuel B. Browne Emmanuel Lansannah-OIC Redemption OPD Tamba Borbor SFP Redemption Hospital

14. Fishbone analysis diagram

15. Recommendations for Improvement DHT provide mentorship to staff on established surveillance protocols provide regular supportive supervision to address rising constraints work with county health team and partners to provide adequate storage and organize workspace for lab staff. work with CHT, partners for timely delivery of supplies and reagents conduct regular training for facility staff on areas where knowledge is inadequate. Health facilities OICs provide staff feedback and positive motivations on performance

16. The District team that is a part of this rewarding training program is very grateful for this opportunity that has allowed them to enhance their skills in epidemiology specifically with surveillance activities. Special thanks go to 1.FETP organizers, sponsors and facilitators 2.Ministry of Health 3.Montserrado County Health Team 4.Local partners For all of the support in making this happen, a big thank you to ALL. Acknowledgement