Table 4 Unique Challenges and Key Learnings in Surveillance and Data Management across the 4 countries
| Â | DRC | Nigeria | Senegal | Uganda |
|---|---|---|---|---|
Surveillance | Expansion of the e-surveillance Testing of all close contacts of a confirmed case (even when asymptomatic) limited by limited test kits Multiple concurrent epidemics (Ebola and Measles) shifting attention and stretching resources Inadequate funding and resources to manage multiple outbreaks Connectivity challenges affecting roll out of electronic systems, system remained mainly paper based. Multiple reporting systems | Hard to reach areas Conflict areas of the North East Logistics for adequate contact tracing Big geography, inadequate laboratory support in parts of the country | All community cases are not documented and there is delay referring to health facilities for some community cases. Limited engagement of scientific team on the national task force delayed interpretation / translation of emerging data and findings into policy with e.g. delay in conducting serological surveys | Delay in evacuation of some positive cases Limitations in timely case detection, investigation and reporting at the district level Centralized EOC with limited use of data by the subnational structures. |
Data management | Existence of multiple data systems renders the integration and use of data very difficult Not all health zones have acquired the digital system Poor internet connectivity in some areas and lack of Tablets and air time | Risk of suboptimal reporting due to stigma Poor use of data to guide decision making at subnational level and some states faced coordination issues | Non-systematic analysis and discussion of data collected and regularly disseminated Community stigma and misinformation influenced demand Multiple reporting applications and mechanisms made coordination difficult Under-detection of cases and variants | Dwindling interest in active reporting from districts Overreliance on donor funding and foreign supplies Limited resources for district coordination |
Key Learnings | Task-shifting to community health workers for contact tracing Develop hotline for case reporting | Leverage experience & systems from past outbreaks Adopt tech solutions that integrate disparate information systems | Leverage government leadership for national communication strategies Enhance multi-sectoral partnerships to boost capacity and innovation | Rapid response and proactive action Initiate community surveys Leverage available funding for innovation |