Table 6 Issues related to IDSR implementation identified during qualitative interviews

1.0 Achievements of IDSR training^a

1.1 Completeness of reporting has improved

1.2 Timeliness of reporting has improved

1.3 Improvement in case detection

1.4 There is better response to outbreaks

1.5 Data analysis has improved

2.0 Reasons for improved confidence in executing IDSR tasks^a

2.1 Capacity building trainings

2.2 Supervision and mentorship

3.0Challenges affecting IDSR implementation^b

3.1 Inadequate number of trained health workers

3.2 Inadequate funding

3.3 Some health workers perceive IDSR to be vertical program

3.4 Irregular supervision

3.5 High turnover of trained health workers

4.0 Recommendations to improve future IDSR training^b

4.1 Train more health workers

4.2 IDSR training should be conducted regularly

4.3 Train community members in IDSR

4.4 Integrating IDSR into pre-service training

4.5 Strengthening IDSR support supervision