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Table 1 Classification of potential surveillance sector gaps with illustrative examples

From: A surveillance sector review applied to infectious diseases at a country level

Gap name Description Example (from the current NZ situation)
A. Leadership & resource gaps
Surveillance leadership and organisational gap Lack of sector leadership, coordination, mandate, and supportive organisational structures No plan for prioritising the development of public health surveillance and limited coordination of existing systems
Surveillance workforce gap Lack of trained workforce in critical areas, such as epidemiology Shortage of epidemiologists and data analysts to review and interpret findings from surveillance systems
Surveillance resource gap Lack of sector resources in critical areas, such as laboratory services and information technology Limited information technology development resources for public health sector
B. Design/structural gaps
Surveillance system gap No surveillance system is established for important disease events, upstream hazards, determinants or interventions No surveillance of most common syndromes in primary care (eg, gastroenteritis)
Surveillance scope gap A surveillance system is established, but its type, range of events covered, and scope of information it is designed to collect does not meet its purpose Surveillance of hepatitis B and C is largely restricted to acute illness rather than chronic infectious cases
Surveillance coverage gap A surveillance system is established, but does not cover all of the necessary populations or settings Absenteeism surveillance and emergency department syndromic surveillance for influenza-like illness is, in each case, confined to only one region in NZ
C. Operation/functional gaps
Surveillance performance gap An established system doesn't meet necessary requirements for key attributes, such as timeliness, sensitivity and validity Reporting of hospital discharges and deaths from infectious diseases is complete but not timely, limiting the value of the information for disease control
Surveillance integration gap Surveillance systems exist but do not link information in a way that supports optimal prevention and control measures Food and water borne disease surveillance is not routinely linked to drinking water distribution zones so limiting its capacity to detect water treatment failures
Surveillance analysis and communication gap Surveillance systems operate but do not analyse and disseminate information in a way that supports effective action Some national data on hospital-acquired infections is collected for health sector monitoring purposes but is not provided to infectious disease practitioners or policy makers