FETP PROJECT WORKBY

DWEADE MUSUEDSO, ST PAUL’S DISTRICT

Introduction Profile of St. Paul District

• St. Paul is one of the districts of Montserrado County.• Boundaries;

• Bomi County (East), Caresysburg district (west), Todee and Bushrod Island (north), and Atlantic Ocean (South)

• Mixed ethnic groups: Kpelleh, Gola, Vai and Congo descents.• The projected population is 119,832

Project work• Expanded surveillance (Epi weeks 31-42)• Problem analysis

Expanded Surveillance Report, St Paul’s District, Week 31-42, 2015,

Summary

• 25 reporting facilities• One zone• No silent facility• Total number of case of immediately reportable disease = 76

( 5 suspected measles, 59 suspected EVD, 9 dysentery, 2 AWD)

• Total suspected EVD =59, none confirmed, no deaths

Facilities

Wk-31

Wk-32

Wk- 33 Wk-34 Wk-35 Wk-36 Wk-37 Wk-38 Wk-39 Wk-40

Wk-41

Wk-42

% Timeliness Current wk-42

% Cumulative completeness wk. 34-42

Kpallah Comm. Clinic L T T T T L T T L T T T 75% 100%

RCD Marshall Comm. T L T L T T T T T T T T 83% 100%

Bromely Comm. Clinic L L T L T T T T L T T T 67% 100% Banjor Comm. Clinic T T T T T L T L T T T T 83% 100% Blamacee Com. Clinic L L L L L T L T L T T T 41% 100% Faith Com. Clinic T T T T T T T T T T T T 100% 100% A. F. Russell Com. Clinic L T T T T L T L L T T T 67% 100%

Timeliness and Completeness of Surveillance Reporting for High Priority Facilities, St. Paul’s District, Epi Week 31-42, 2015

LEGEND

This week On time

T

Late

L

No report received

NR

% Cumulative

>=80% on time

>=50-79.9% on time

<50% on time

Cumulative Timeliness of Weekly Surveillance Reporting of High Priority Facilities, St Paul’s DistrictEpi Week 31-42, 2015,

• Faith community clinic:100% timeliness despite high patient load

• Action taken: League tables were displayed at the District office. Subsequently, all facilities strive to report timely.

Kpallah comm clinic

RCD Marshall Clinic

Bromley Comm. Clinic

Banjor Comm Clinic

Blamacee Comm Clinic

Faith Comm Clinic

A.F. Russell Comm Clinic

0

20

40

60

80

100

120

% timeliness

Summary of Notifiable Diseases, St. Paul’s District, EPI Week 31-42, 2015

Disease Case Death Case Fatality Rate (%)

(AFP) 0 0 0Measles (suspected) 5 0 0NNT 0 0 0EVD (suspected) 59 0 0Cholera 0 0 0Dysentery 9 0 0Lassa Fever 0 0 0Yellow Fever 0 0 0Meningitis 0 0 0Human Rabies 0 0 0Other VHF 0 0 0AWD 2 0 0

Trend of EVD Cases And Deaths, St Paul’s District, EPI WEEKS 31-42, 2015

meeting with OICs to improve surveillance

sensitization of facility staff about change in case definition of EVD

Public Health Action:

Samples still being tested from all suspected EVD; None confirmed

31 32 33 34 35 36 37 38 39 40 41 420

5

10

15

20

suspected EVD cases suspected EVD deaths

Epi weeks

num

ber

Surveillance Quality Problem Analysis

Incomplete Reporting on Immediately Reportable Diseases From Health Facilities

Method

• Identified the problem• Formed an inquiry team• Brainstormed • T,P,N Analysis• Critical cause• Improvement recommendations

Problem Analysis Team Members

• District Surveillance Officer: Dweade R. Wilson• Zonal Surveillance Officer: Jamesetta Kemokai• Officer In Charge:(Kpallah Comm. Clinic):Wislyne Sieh• Officer In Charge:(Gbondoi Health Center):Marion Bropleh

STAFFHEALTH FACILITIES

ADMINISTRATION LAB FACTORS LOGISTICS

Inadequate number of staff (N)

Poor attitudes in personne (P)l

Over work load (N)

Inadequate training in surveillance(p)

Inappropriate data capture variables on the forms (P)

Inadequate availability of reporting

formats (P)

Poor network courage(N)

Lack base radio in some areas (N)

Poor feedback mechanisms from reference laboratory (N)

No training in sample collection (P)

There are inappropriate supplies (raid kits, swabs, culture medium) for identifying IRD’s .(P)

Non functional Labs (lab structure without lab )technicians(N)

Lack of graphics, illustrations on facilities walls (P)

Lack of surveillance focal person in the health facility (P)

Standard case definitions not available to staff in the health facility (P)

Lack SOPs on priority diseases (T)

No evaluation or feedback on staffs performance (P).

Validation of data process is inaccurate from the health facilities (P).

Inadequate Training of health facility staff In

Surveillance About The Priority Diseases

Incomplete reporting on im

mediately

reporting diseases from health

facilities

Critical Cause• Inadequate Training of Health Facility Staff In Surveillance of

the Priority Diseases

Other contributory factors• Overwork of Staff• Poor Attitude of Personnel• Inappropriate Data Capture Variables on lab forms• Poor Feedback from Reference Laboratory

Recommendations for Improvement

• DHT: • Training of health facility staff on

• the case definitions of IMRDs• Collection and labeling of samples

• Ensure graphic illustrations are displayed on the walls of Health Facility depicting their monthly activities.

• MCHT: To evaluate facilities regularly to identify those that are under-staffed and overworked

• Partners: To re-design surveillance reporting forms to include variables that will self explain the case or event that has happened.

ACKNOWLEDGEMENT

FETP family

MOH family

DHT family

CDC, WHO

Government of Liberia

May God richly bless all of us

THANK YOU