1. Ministry Of Health Field Epidemiological Training Program (FETP) Final Presentation
Moses K. Beyan, Dso Somalia Drive Health District Montserrado County-liberia November 2-3, 2015

2. Expanded Surveillance Summary Report EPI
Introduction
Somalia drive district
Sixty six (66) HFs→Government-6, Private-60
Four (4) zones (1100B1, 1200, 1300 & 1400)
An estimated population of 275,622
Highlights
Expanded Surveillance Summary Report EPI
Week 31-42, 2015
Surveillance Quality Problem Analysis

3. Summary Reporting quality Disease reports
Expanded Surveillance Report for Somalia Drive District EPI weeks
Summary
Reporting quality
Disease reports

4. Summary Total Number of IMRD = 312
susp EVD-126, susp. Measles-53,Neonatal Tetanus 4,Acute Water Diarrhea-33,Non-Bloody Dysentry-58,Susp. Meningitis-3, Human/Dog bite-8, Maternal Death-1 & Neonatal Death-18
Suspected EVD Cases 126:
All live cases
Specimen were collected & sent to lab, few negative results received by DHT
Continuous follow-up on remaining results.

5. Reporting Quality
High priority Facilities Reporting on Timeliness & Completeness EPIwk.31-42, 2015
FACILITY
WK. 30 31
Wk. 32 33
Wk.34
Wk.35
Wk. 36
Wk. 37
Wk. 38
WK. 39
WK. 40
WK. 41
WK.42
% CUM. Timeliness
% CUM.
Completeness
James N. Davis Hospital T L
69%
100%
Gardnerville Comm. Clinic NR
R. H. Ferguson Clinic
Sis. Barbra H. Center
62%
MSF Hospital
77%
New Georgia Health Center
92%
Chocolate City Health Center
Barnesville Health Center
LEGEND:
On Time T
Late L
No report
(NR)
%CUM. Timeliness
% CUM.
Completeness

7. Comments on Reporting Quality
50% achieved National Target of ≥ 80% for Timeliness
75% exceeded National Target of 80% for completeness
Gardnersville Clinic & Barbra Ann HC least performed among high priority Facilities
under performance due to lack of motivation or wrong perception
One facility remained silent despite formal communication served from county.
PUBLIC HEALTH ACTION
DHT continues to engage under-performed HFs in order to improve on their reporting.

8. Summary of Key Notifiable Diseases & Events, Epi Week 31-42
CASES
DEATHS
CUMULATIVE CASE FATALITY RATE
AFP 0%
Suspected EVD
126
Suspected Measles 53
NNT 4
AWD 33
Non-bloody Dysentery 58
Lassa Fever
Yellow fever
Other VHF
Suspected Meningitis 3
Suspected Cholera
Human/ Dog Bites 8
Maternal Death 1
Neonatal Death 18

10. Comments
Increase cases of dysentery that peaked at wk 35 probably because to constant flooding of communities due to the raining season
increase suspected measles cases at week36
findings revealed parents refusal to get children vaccinated especially part of Iron Factory community
There was no death from all suspected and/or reported cases
PUBLIC HEALTH ACTION
Vigorous outreach vaccination against measles by HF & ZSO
Non-bloody dysentery, treated & discharged no sample collected

11. Surveillance Quality Problem Late Surveillance Reporting in the Somalia Drive District
The District continues to struggle with timely reporting since its formation.
From the backdrop that surveillance is an information for action, any factor that hinders the timely transmission of its finding/information to next level requires key consideration for resolution.
The surveillance team along with one OIC gathered at District office to discuss the problem, causes and way forward

12. Problem Analysis Team Members
Moses K. Beyan, DSO Somalia Drive District
John P. Kromah, ZSO Zone 1100B1
Alexander G. Toe, ZSO Zone 1300
Nathaniel Ballah, ZSO Zone 1200
Mally Biah, OIC Barnesville HC

13. FISHBONE DIAGRAM ADMINISTRATION POLICIES PROBLEM
Legend:
N: Not in my control
P: Partially in my control
T: Totally in my control
ADMINISTRATION
POLICIES
Lack of motivational package (N)
Weak National Policies (N)
Inadequate Logistics Communication & gas (N)
No fear of discipline for non-compliance (N)
Inadequate Training of HFs’ Staff (P)
Lack of Data Officer (N)
CRITICAL CAUSE
Wrong Perception about Surveillance reporting among Health Facility Staff
PROBLEM
LATE SURVEILLANCE REPORTING IN THE SOMALIA DRIVE DISTRICT
Under staff of DHT (N)
Bad Road Condition (N)
Wrong perception about surveillance reporting among HF Staff (T)
Poor traffic system on the Somalia Drive (N)
High Workload (N)
High Staff Attrition (N)
ENVIRONMENT
PERSONNEL

14. Improvement Recommendations
DHT to initiates an awareness campaign intended to change/erase the wrong perception about surveillance cultivated by some facility staff
County Health Team provide motivational package to health facility staff involve with surveillance-scratch card and/or financial reward
Surveillance team focus on surveillance activities in the district- supervision, report collection, etc
Regular refresher Training for all health facility staff in all aspect of surveillance; especially for case definition/detection and reporting
That National Government reinforces policy if there be any for surveillance reporting.

15. I am grateful to all for the support and training
Acknowledgement
I am grateful to all for the support and training
MCHT
MOH
Mentors
Training Leads
CDC Partners

16. THANK YOU.