1. Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme LFETP) FIELD WORK 2 -Expanded Surveillance Report- -Surveillance Problem Analysis Report- Augustine Tuma County Surveillance Officer Cape Mount County Health Team 1

2. Liberia Field Epidemiology Training Programme (LFETP) 2 Expanded Surveillance Report

3. Liberia Field Epidemiology Training Programme (LFETP) Introduction Cape Mount County is located in western Liberia Has 5 health districts with 33 health facilities Community Health Facility District Surveillance Office National surveillance office County Surveillance Office Communication Flow 3

4. Liberia Field Epidemiology Training Programme (LFETP) Disease Summary 1/2 Summary of reported key notifiable diseases, Cape Mount County, 2015 Disease cumulative Week 31 - 42 CasesDeathsCase Fatality Rate (%) Suspected EVD cases870566 Acute watery Diarrhea6300 Bloody Diarrhoea100 Suspected AFP000 Cholera000 Yellow Fever000 Lassa Fever000 Rabies000 Maternal death500 Neonatal Death100 Measles500 Meningitis000 4

5. Liberia Field Epidemiology Training Programme (LFETP) Disease Summary 2/2 The zero case reporting requirement met by all 5 heath districts. Classification of cases: EVD 870(S) 0 (C) Measles 5(S) 0 (C) AWD 63 (S) Laboratory results for suspected measles and suspected EVD cases were all negative. Suspected cases were reclassified as non- cases. *S = suspected; C = confirmed 5

6. Liberia Field Epidemiology Training Programme (LFETP) Timeliness and completeness of reporting by districts, Cape Mount County, 2015 6 % Cumulative >=80% on time/Complete >=50-79.9% on time/Complete<50% on time/Complete legend Districts Before FETP (Week 19-30) DURING FETP (Week 31-42) % Timeliness% Completeness% Timeliness% Completeness Rabort Sport4210075100 Garwula810050100 Gola Konneh7510075100 Tewor5810083100 Porkpa4210042100 Means4510065100

7. Liberia Field Epidemiology Training Programme (LFETP) Trends of Acute watery Diarrhea Grand Cape Mount Epi week 31-42, 2015 7

8. Liberia Field Epidemiology Training Programme (LFETP) Trend of Measles Cases Cape Mount County, Epi week 31-42, 2015 8

9. Liberia Field Epidemiology Training Programme (LFETP) Activities carried out between week 31-42 Suspected measles outbreak investigation in Garwula district IDSR rollout and training for health facility staff in county Case investigation of Maternal and Neonatal deaths Weekly feedback of districts and health facilities performance Dissemination of weekly surveillance reports 9

10. Liberia Field Epidemiology Training Programme (LFETP) 10 Surveillance Problem Analysis Report

11. Liberia Field Epidemiology Training Programme (LFETP) Introduction The effectiveness of a surveillance system can be judged by the quality of data collected To help identify surveillance gaps in my county, SWOT analysis was conducted Key issues identified – Late reporting on surveillance data – Poor team work – Lack of communication 11

12. Liberia Field Epidemiology Training Programme (LFETP) Methods A team of surveillance officers was formed -CSO – OIC’s – DSO Fishbone analysis was conducted; – Identify factors contributing to late reporting on surveillance data – Narrowed down to the critical cause – Made recommendation 12

13. Liberia Field Epidemiology Training Programme (LFETP) Fishbone analysis on late reporting on surveillance data, Grand Cape Mount, 2015 Insert Fishbone N = Not within controlP = Partially within control T = Totally within control 13

14. Liberia Field Epidemiology Training Programme (LFETP) Critical cause Lack of supervision was identified as critical cause Major areas in surveillance lacking supervision – Data management and reporting – Logistic management – Staff management and training Key factors contributing to lack of supervision -Lack of communication – Bad condition of roads – Inadequate logistic – Inadequate training 14

15. Liberia Field Epidemiology Training Programme (LFETP) Recommendation CSO to conduct refresher training for staff on data collection, reporting tools and reporting channels (T) MoH to provide vehicle/motor bike to facilitate movement to sites (P) OIC, DSO, CSO to encourage good staff working relationship (T) Liberia Government to constructs good accessible roads (N) 15

16. Liberia Field Epidemiology Training Programme (LFETP) Public health action Regular supervision and training on data collection Improved data quality and timeliness of reporting at all levels; – Facility level – District Level – County level 16

17. Liberia Field Epidemiology Training Programme (LFETP) Acknowledgement Ministry of Health, Liberia Field Epidemiology Training Programme, Liberia Emory University Centers for Disease Control and Prevention African Field Epidemiology Network World Health Organization My Mentors – Stephen and Joseph 17