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Table 4 Zanzibar IDSR implementation challenges by the healthcare delivery system level

From: Assessment of the core and support functions of the integrated disease surveillance and response system in Zanzibar, Tanzania

Level Expressed challenges
National Lack of electronic system/database for infectious disease reporting
Inadequate financial resources for conducting regular supervision visits and training
Lack of back-up system for data security
District Lack of electronic system for infectious disease reporting
Inadequate resources including fund for conducting supervision visits
Low staff knowledge on IDSR strategy particularly at health facilities
Delay of reports from health facilities particularly privately owned
Poor communication system for reporting suspected outbreaks
Unreliable internet service
Lack of incentives for IDSR reporting leading to low staff motivation
Health facility High staff workload
Filling paper-based surveillance forms time consuming
Late report collection by DSOs
Absence of airtime vouchers for submitting weekly cell phone-texted data
Lack of regular trainings or capacity building on disease surveillance and IDSR reporting tools
Inadequate supervision and feedback from higher levels
Lack of designated personnel responsible for IDSR at the hospital level