Trained district health personnel and the performance of integrated disease surveillance in the WHO African region.

BACKGROUND African countries have intensified in-service training on Integrated Disease Surveillance and Response (IDSR) for district and facility health personnel to strengthen their disease surveillance systems. Eight countries evaluated their experiences and lessons in the implementation of IDSR. METHODOLOGY We conducted a secondary analysis of the evaluation reports to assess the impact of training of district health personnel on the performance of disease surveillance systems. We developed indicators to assess the potential impact of their training on the timeliness and completeness of reporting, the data analysis of priority diseases at the district and health facility levels and supervision and feedback at the district level FINDINGS Training approaches implemented included cascade, on-job, pre-service and fast track training on detection, reporting and data analysis. The overall proportion of health facilities with one or two personnel trained varied from 52% to 89% and the knowledge of the health personnel for epidemic-prone diseases ranged from 52% to 78%. All the countries met the threshold of 60% of health personnel in their districts trained in IDSR. The evidence from data analysis at the district level was more than 60% and the timely reporting and completeness of health facilities 70% and 92%, respectively. Supervision of health facilities ranged from 75% to 100%, however feedback was not provided on a regular basis CONCLUSIONS Trained district personnel are key in the performance of the national IDSR. This review shows that training of district health personnel coupled with sustainable supervision and feedback, reliable communication and availability of simplified reporting tools can contribute to improved performance of national diseases surveillance systems.