- IDSR Technical guidelines and standard case definitions were available in all offices but no evidence of usage by the staff
- Very few private health facilities participated in IDSR implantation and reporting
- No evidence of community based surveillance
- No evidence of analysis of IDSR data other than on polio eradication initiative activities
- All staff interviewed knew only timeliness and completeness as the core indicators for IDSR at both health facility and Local Government Areas levels
- Supervision to the lower levels were done but there were no reports seen
- The IDSR supervisory checklists were not used
- There was no evidence of written feedbacks to the supervisees
- Lack of motorbikes to facilitate supportive supervision
Local government levels
- IDSR technical guidelines and list of standard case definitions were available in the Local Government Areas offices but were not put to used.
- DSNOs limit collection of IDSR data to only designated focal sites for AFP surveillance of the polio eradication initiatives
- There was no evidence of recent analysis of IDSR data
- There were supervisory visits to the lower levels but there were no reports of the activities.
- Supervision were not done with the IDSR standard supervision checklists
- Staff had been trained but there was no focus on basic concept of IDSR, identification, reporting, analysis and response to outbreak of diseases.
- All the outpatient registers reviewed revealed missing data
- Staff interviewed complained of lack of means of transportation for supervision and retrieval of IDSR data from the health facilities
- The staff interviewed knew only timeliness and completeness as the core indicators for IDSR at the health facility level.
- Lack of motorbikes for retrieval of surveillance data from the health facilities, supportive supervision, verification and response to outbreaks of diseases, conditions and events.