1. First experience of a health and demographic surveillance system (HDSS) in an MSF project
Jerlie Coraldine Loko Roka1, Cristian Casademont2, Susana Villen Iglesias3, Amabelia Rodrigues4
1Médecins Sans Frontières (MSF), Dakar, Senegal; 2MSF, Barcelona, Spain; 3MSF, Bissau, Guinea-Bissau; 4Bandim Health Project, Bissau, Guinea-Bissau

2. Background Msf in more than 60 countries worldwide
Low and middle income
Different contextS (armed conflict, natural disasters, outbreakS…)
Different lengTHS of stay (few weeks to many years)
Common issue: lack of accurate and reliable data

3. Background Importance of Data
Guide interventions and fit them to population needs
Monitor activities oVER time
Assess population impact of interventions and adapt them when needed
Provide care using evidence-based health system

4. Background HDSS is intensive longitudinal data collection with:
Open cohort follow-up over time
Cohort Living within a limited geographic boundAry
Samuel Clark, University of Washington; Health and Demographic Surveillance Systems and the Post-2015 Agenda

5. Background In middle and low income countries, 52 HDSS sites
organised in an international network INDEPTH based in Accra
Guinea-Bissau has been an HDSS site since 1978
INDEPTH=International Network of Field Sites with Continuous Demographic Evaluation of Populations and Their Health
MSF take advantage of BHP experience to implement HDSS in Bafata with the aim of improving the quality of surveillance data used to guide our interventions

6. Methodology Study setting
Bafata is one of the eight regions Of Guinea-Bissau
MSF present in Bafata since 2014
Five year project
Pediatrics activities
Research component
HDSS implementation
Follow up through home visits every 6 months

7. Methodology Baseline census Sampling Data collection Revisit
HDSS implementation through Bandim Health Project (BHP)
40 clusters randomly selected
women of reproductive age ( years)
and children aged <5 years
Baseline census
Sampling
Data collection
Revisit
Data Analysis
Follow up through home visits every 6 months

8. Methodology Routine data collection Sociodemographics
Vital statistics (Birth, death and migration)
Verbal autopsy on cause of death
Anthropometric data
Health seeking behavior
Health care access
Focused upcoming studies
Malaria drug resistance
Follow up through home visits every 6 months

9. Preliminary Results We registered 3481 women of reproductive age (wra)
Young teenagers (12-17 years) constituted 16% of WRA
and 3637 children <5 years
At baseline,
the prevalence of severe acute malnutrition among children aged 6-59 months was 0.7% (17/2503; 95%CI ).
12.4% (424/3426) of children <5 years reported an illness in the past month,
of whom 70.2% (271/386) consulted a health facility and
13% (42/131; 95%CI ) sought a traditional healer;

10. Preliminary Results in the past 6 months
1.4% (49/3479) had been hospitalised
In the first 6 months of the project, neonatal mortality was 1.6% (95%CI )
measles vaccination 64.1% (95%CI )
full EPI * 52% (95%CI )
*(expanded programme on immunisation)

11. Conclusion dynamic view of the population over time
Use of HDSS by MSF would allow projects to adjust to real-time needs
(Enabling rapid identification of trends / new health concerns / population movements)
allows monitoring of the impact of health interventions
potentially improve health-care provision in areas where MSF plans to remain for many years

12. Thank you for your attention