Professional Documents
Culture Documents
Abstract
Successful implementation of Integrated Disease Surveillance and Response (IDSR)
programme no doubt, depends a lot on adequate awareness, knowledge, positive
attitude and best practices of all personnel involved in the system. In this study, a
sample of 50(fifty) Health Information Management (HIM) professionals were drawn
from a HIM population of 97 (ninety-seven) under the FCT HHSS, using proportional
allocation technique. Their knowledge, attitude and practice towards the IDSR
programme were assessed using the KAP survey. Findings show that HIM professionals
of FCT HHSS are adequately aware and also have very good knowledge of the IDSR
system in FCT, Abuja. They generally exhibit positive attitude towards the programme
but are however in general, not able to perform most of the core IDSR functions like
Trend Analysis. It is recommended that amongst others, for data collection and analyses
to be very effective, there should be training and retraining programs for the HIM
1
professionals in the hospitals. This will hopefully improve their computational and
mathematical skills thus enabling them perform all core functions of the IDSR practices.
(Tags: Assessment; Health Information management; Integrated Disease Surveillance
& Response; Knowledge; Attitude; Practice; KAP Survey;
CHAPTER 1.0
INTRODUCTION
It is cheap, since the same health personnel and reporting formats are used for
routine reports of health-related data.
It creates an opportunity to computerize all the available data at the central level.
It provides training and capacity building opportunities for health personnel
including Health Information Management professionals, to develop new skills.
health decision making and practice. Surveillance provides crucial information for
monitoring the health of the public, identifying public health problems, and triggering
action to prevent further illness. Such information is vital to the nation's health, and its
analysis and dissemination frequently affect everyday life and clinical practice. Disease
surveillance equally provides data about the incidence of disease in the community
data that can help raise or lower the threshold of clinical suspicion for a particular
infectious disease, encouraging early detection and appropriate treatment and perhaps
avoiding unnecessary treatment, and treatment for the wrong disease. Public health
4
surveillance data are readily available. Local and state health departments disseminate
data specific to their jurisdiction, often in periodic newsletters available to the public.
Thus, IDSR is a cost-effective surveillance system which addresses the major health
problems in Nigeria. Many other countries in sub-Saharan Africa such as Ghana and
The Gambia, have adopted a similar IDSR system, (Abubakar et al, 2013).
As noble as the IDSR system has come to be, there are some major concerns
which providers (facilities) have to contend with. For example, providers are
understandably concerned about the burden of reporting an increasing number of
infectious diseases to public health authorities. To avoid duplication of data entry and to
make efficient use of the National Hospital Management Information Systems,
providers have to work with relevant authorities to ensure direct reporting from their
laboratory data systems to public health agencies and to devise mechanisms for
obtaining inpatient and outpatient data for surveillance purposes directly from their
administrative data systems. Secondly is the issue of patient confidentiality. Healthcare
providers may be apprehensive about sharing computerized patient records for instance,
with outsiders. However, to do their job of protecting the health of the public, local
public health agencies routinely have access to sensitive personal information, such as
data on sexually transmitted disease contacts or sexual or other risk factors for disease.
The public health community thus should have an excellent history of safeguarding
patient confidentiality and using these data exclusively for public health purposes.
Without such information, public health officials cannot track persons at risk for disease
and thus prevent further spread of illness. Fear of loss of confidentiality has been used as
an argument against sharing electronic medical data for public health purposes.
However, electronic information systems can make medical data even more secure than
they are in paper-based medical records. It is important to reassure the public that health
facilities do protect the confidentiality of the data they gather, and must make the case
that these data are essential for preventing the occurrence and spread of disease. Both
managed care and public health organizations are concerned with population-based
5
healthperhaps together they can show the public the value of medical records for both
clinical research and public health practice.
A third concern of the IDSR system is the health facilities concern for their own
confidentiality. Some facilities may fear that data will be used to measure their
performance and efficiency against that of other facilities, particularly with regard to
items not entirely under their control, such as disease incidence. It is important for
higher relevant authorities to reassure hospitals that public health surveillance is not a
regulatory function and that the purposes in conducting surveillance are to monitor the
public health and to identify opportunities for improving community health status.
Furthermore, data shared with public health organizations can be used only by public
health officials to identify problems or priorities and to take public health action. They
cannot be shared with secondary users except under conditions that guarantee
confidentiality.
Building of trusting partnerships helps facilitate timely and mutually beneficial
sharing of data between managed care organizations and public health agencies.
Underreporting has also been reported as a challenge to the IDSR system. Physicians
and other health care providers often do not report diseases to the local health
department. Some diseases that cause severe clinical illness (e.g., plague and rabies) are
probably reported accurately once they are diagnosed. However, persons with diseases
that are clinically mild and infrequently associated with serious consequences (e.g.,
salmonellosis) might not seek medical care from a health care provider. Even if these
diseases are diagnosed, they are less likely to be reported. Underreporting occurs
because, in general, few health care providers understand the importance of public
health surveillance, the role of the provider as a source of data, and the role of the health
department in response. Many providers do not know how or to whom to report
diseases. Some of this lack of understanding is due to the failure of public health
agencies to provide feedback on how data are used or to make data available to
providers or other potential users of the data.
In Nigeria, the disease surveillance system was actually introduced in 1988
following a major outbreak of yellow fever in 1986/87, which affected ten out of the
then nineteen States of the Federation. The magnitude of the outbreak was attributed to
weak or non-existent disease surveillance and notification system in most States. As a
result of this, a task force was established by the Federal Ministry of Health to review
disease surveillance and notification in the country. Between 1988 and 1989, a disease
surveillance and notification system for the country was developed. Forty diseases of
public health importance in the country were identified and designated for routine
(monthly) notification out of which ten epidemic prone diseases were selected for
immediate reporting. Standard reporting forms (DSN 001 for immediate reporting, and
DSN 002 for Monthly routine reporting) were also introduced. The methodology for
information flow between the various levels was also prescribed. In 1989, the National
Council on Health approved the adoption of Disease Surveillance and Notification
(DSN) in the country.
The Integrated Disease Surveillance system seeks to ensure that effective and
functional systems are available at each level of the healthcare system; from facilities to
Local Government areas (LGAs), states and at the national level. IDSR focuses on the
LGA level where information generated is used for timely action consequently leading
to reduction in morbidity, disability and mortality. Abubakar et al., 2013 state that a
country where IDSR is functional would use standard IDSR case definitions to identify
and report priority diseases; collect and use surveillance data to alert higher levels to
trigger local actions; investigate and confirm suspected outbreaks or public health events
using laboratory confirmations, when indicated; analyze and interpret data collected in
outbreak investigation and from routine monitoring of other priority diseases; use
information from the data analysis to implement an appropriate response; provide
7
feedback within and across levels of healthcare system; and evaluate & improve the
performance of surveillance and response system.
The flow of information in the IDSR system in Nigeria is from the health facility
where diseases that have epidemic potentials, which are targeted for eradication and
elimination, are reported immediately to the focal persons in the health facility and to
the LGA. The LGAs receive data from the health facilities, collate and send to the next
level which is the State Ministry of Health (SMOH). At the LGA level, analysis and
feedback to the health facilities are usually carried out. The Epidemiology Unit of the
SMOH collates data from the LGAs and forwards them to the Epidemiology Division of
the Federal Ministry of Health (FMOH). At the SMOH, analysis and feedback to the
health facilities and the public are done as well as planning appropriate operations and
strategies for disease control. At the FMOH, data is collated and forwarded to the
Statistics Division, analysis and feedback are carried out, as well as planning for
appropriate intervention based upon the results of the analysis.
The goal of IDSR also seeks to improve the ability of Health Information
Management (HIM) professionals and other health workers to detect and respond to
diseases and conditions that cause high rates of death, illness and disability in the
communities thereby improving health and well being for the communities. The
National IDSR unit has developed a comprehensive database of the 21(twenty) priority
communicable diseases and provided data management guidelines for use at all levels.
Standard case definitions of priority diseases has been produced, and circulated to all
implementing health facilities, LGAs and States. Workshops have been conducted to
sensitize decision-makers on the use of data generated for decision-making and policy
formulation. Data is disseminated through a two-way feedback process, such as monthly
newsletter at all levels and the quarterly National Bulletin of Epidemiology (NBE) at the
Federal level. Surveillance officers which included HIM professionals, at all levels had
been trained in effective data management .IDSR is now an integral part of the overall
8
1.3
At the end of this research, results obtained would be significant in the following ways:
1. It would bring to fore the level of knowledge, attitude as well as the standard of
practice of HIM professionals towards IDSR.
2. It would form a basis for additional training of HIM professionals thus enabling
them to contribute adequately in the smooth implementation of the IDSR system.
3. It would no doubt, become a reference material for the Human Resource
Management of the FCTA when considering deployment and training.
4. It would form a basis for further research in this subject matter.
1.4
1. Are there available, IDSR forms and other relevant tools for the IDSR system in
FCTA Healthcare facilities?
2. Do HIM professionals know how to make effective use of these IDSR forms in
their facilities?
Survey
Knowledge, Attitude, and Practice (KAP) surveys are widely used to gather
information for training of personnel and planning public health programmes. However,
there is rarely any discussion about the usefulness of KAP surveys in providing
appropriate data for training, project planning, and decision making (Annika, 2009). The
KAP survey tradition was first born in the field of family planning and population
studies in the 1950s. KAP surveys were designed to measure the extent to which an
obvious hostility to the idea and organization of family planning existed among different
populations, and to provide information on the knowledge, attitudes, and practices in
family planning that could be used for programme purposes around the world (Cleland
1973, Ratcliffe 1976). In the 1960s and 1970s, KAP surveys began to be utilized for
understanding family planning perspectives in Africa (Schopper et al. 1993). Around the
same time, the amount of studies on community perspectives and human behaviour
grew rapidly in response to the needs of the primary health care approach adopted by
international aid organizations. Hence KAP surveys established their place among the
methodologies used to investigate health behaviour, and today they continue to be
widely used to gain information on health-seeking practices including towards disease
surveillance and response, (Hausmann-Muela et al. 2003, Manderson and Aaby 1992).
11
knowledge and attitude level. KAP surveys have been criticized for providing only
descriptive data which fails to explain why and when certain practices are chosen. In
other words, some surveys fail to explain the logic behind people's behaviour
(Hausmann-Muela et al. 2003, Nichter 1993, Pelto and Pelto 1994, Yoder 1997).
Another concern is that KAP survey data is often used to plan activities aimed at
changing behaviour, based on the false assumption that there is a direct relationship
between knowledge and behaviour. Several studies have, however, shown that
knowledge is only one factor influencing practices, and in order to change behaviour,
health programmes like the Integrated Disease Surveillance and Response need to
address multiple factors ranging from ergonometrical, socio-cultural to environmental,
economical, and structural factors, etc. (Balshem 1993, Farmer 1997, Launiala and
Honkasalo 2007).
2.2
occurrence of quarantinable diseases namely cholera, plaque and yellow fever. In 1893
same Congress directed weekly reporting from Municipal services. By 1903 effort
began towards the standardization of format for data collection by producing relevant
forms. In 1913, the US Government directed the Public Health Services, PHS to send
weekly telegraphic summaries. The National office of Vital Statistics (NOVS) was thus
created in the PHS office. Until 1950, weekly report was published in public health
reports but later became the Morbidity and Mortality Weekly Report and was then
transferred to the Centers for Disease Control, (CDC).
In recognition of the defect in the disease surveillance and notification situation
in the African continent, Nigeria and other member States in the WHO African Region
endorsed the Integrated Disease Surveillance and Response strategy at the 48 th Regional
Committee meeting held in Harare, Zimbabwe, in September, 1998. Nigeria has since
then embraced the new IDSR strategy and has also introduced it in all the States of the
Federation and Federal Capital Territory (FCT). The Public Health Division of the FCT
Health & Human Services Secretariat coordinates the IDSR programme in the FCT.
However, the implementation strategy started in June 2000, with an orientation
workshop held to sensitize national program managers of vertical programmes and
partners on IDSR strategy. This strategy integrates multiple surveillance systems, so that
personnel and other resources are utilized more efficiently and effectively. An integrated
approach means that data on all important diseases will be collected, analyzed,
interpreted and reported in the same way, by the same people who normally submit
routine report forms on health-related data. A functional disease surveillance system
equips health workers to set priorities, plan interventions, mobilize and allocate
resources and provide early detection and response to disease outbreaks. This requires
the effective coordination and synergy between personnel and IDSR activities. Among
the basic ingredients of the IDSR are an effective communication system, a clear case
definition and reporting system and a network of motivated personnel whose
16
knowledge, attitude and practice are geared towards the smooth implementation of the
IDSR strategy.
In January 2001, a steering committee on IDSR was inaugurated to steer the
implementation process. In June 2001 the steering Committee carried out an assessment
of the surveillance system with a view to obtaining baseline information on the existing
disease surveillance system in the country. Among their findings include the problem of
incomplete and untimely reporting which were largely traceable to the level of
knowledge, attitudinal pre-disposition and the quality of practices of personnel which
now includes the Health Information Management professionals. Based on this finding,
they recommended, amongst others, relevant trainings of personnel for IDSR. Many
years after this recommendation, it appears that much improvement has not been
witnessed in the area of Knowledge, Attitude and Practice (KAP) of personnel on IDSR
strategy. This can be noted when Chinomnso et al (2012) posit that in Nigeria, the
collection, collation, analysis, and interpretation of data in health-care facilities which of
course are the major responsibilities of the HIM professionals, are often unsatisfactory,
partly due to insufficient awareness among health-care personnel on the importance of
this process. This process refers to the channel of transmission of data. Here, the healthcare facility, which could be public or private, is the first level for the generation of
health-care facility-based data, and it also receives records from community-based
health-care workers serving within its catchment area. The health-care facility staff
collects the data at this level, fills, and sends the necessary IDSR forms on a weekly or
monthly basis or immediately depending on the condition of disease or health care.
These results are sent to the Local Government Primary Health Care Department
(Monitoring and Evaluation Unit), which collates data from various health-care facilities
in the locality and sends these to the State Ministry of Health (Epidemiology Unit).
These data are analyzed before transmission to the Federal Ministry of Health
(Epidemiology and Planning Research and Statistics Unit) for national collation,
17
data. Maintaining data quality is a very crucial role of health information management in
the IDSR programme. This, among other functions requires thoroughly going through
the data periodically and scrubbing it. Typically this involves updating it, standardizing
it, and de-duplicating records to create a new single view of the data, even if it is stored
in multiple and disparate systems. By virtue of their training, HIM professionals are
able to support the smooth implementation of the IDSR strategy by facilitating the
availability of timely, relevant, and high-quality information through adequate and
efficient completion of the IDSR forms, (see Savel, 2012). They improve the efficiency
and effectiveness of IDSR systems through innovative data collection and analysis. This
crucial role demands the assessment of their knowledge, attitude and practice towards
IDSR.
19
Name of Facility
No.
of
Percentage
(h)
Nyanya
professionals (Nh)
General 9
(nh)
4
sample drawn
8
Hospital
Maitama
District 10
10
Hospital
Asokoro
District 17
18
Hospital
Wuse
District 15
16
Hospital
Gwarinpa
District 9
Hospital
Kubwa
General 8
Hospital
Bwari
General 8
Hospital
Karchi
General 7
Hospital
Kuje
General 5
(%)
of
Hospital
20
10
Abaji
General 4
11
Hospital
Robochi
General 3
12
Hospital
Kwali
General 2
Total
Hospital
12
50
100
97
Table3. 1: Number of HIM Professionals drawn from each facility following Proportional Allocation.
Fig. 3.1: Chart showing the number of HIM Professionals drawn from each hospital by proportional allocation.
candid and objective data. The type made use of here is the self-administered,
structured Questionnaire. This is in cognizance of the level of the academic
qualification and work experience of the population under study.
The Report refers to FCTA Health & Human Services Secretariat Annual
report from which data and information relevant to the study were extracted. The
Reliability and Validity of this report rest completely outside the control of the
researcher, but within that of FCT HHSS. Where Interviews were needed, it only
served for clarification purpose and for follow-up. In fact, Borge et al (1993)
observe that Questionnaires are often used to collect basic descriptive information
from a large sample, while Interviews are used to follow-up Questionnaires. The
three (3) instruments adopted here: Questionnaires, Interview and the Reports,
were used in the study for the purpose of triangulation and confirming information
collected from various sources. The researcher had hoped that, by adopting these
methods, sampling errors due to bias might be adequately minimized.
22
Once the coding were completed, the Responses and Results would be cumulated
and converted to Totals, Averages, and Percentages .The chapter would also dwell
on the discussion of the results of the analyses table by table after each analysis.
These discussions would enable the drawing of the final conclusion at the end of
the report.
4.2
Name
of No.
Facility
of Respondent Male
Female
HIM
Resp.
Profession
Female)
(M.R.)
( F.R.)
% M.R % F.R
1
2
Nyanya GH
Maitama
als
9
10
4
5
1
2
3
3
25
40
75
60
DH
Asokoro
17
44
56
4
5
DH
Wuse DH
Gwarinpa
15
9
8
4
3
1
5
3
38
25
62
75
6
7
8
9
10
11
12
Total
DH
Kubwa GH
Bwari GH
Karchi GH
Kuje GH
Abaji GH
Robochi GH
Kwali GH
12
8
8
7
5
4
3
2
97
4
4
4
3
2
2
1
50
2
1
1
0
0
1
0
16
32%
2
3
3
3
2
1
1
34
64%
50
25
25
0
0
50
0
50
75
75
100
100
50
100
24
Table 4.1 above shows that, of the 4 Respondents in Nyanya General Hospital,
as high as 3 of them were female while 1 was a male officer constituting only 25%
of the respondents in the hospital. Also75% respondents in each of Gwarinpa,
Bwari and Karchi General Hospitals respectively, are all females. However, at
Maitama District Hospital, 60% of the respondents were female while 40% were
male. Interestingly, while all the respondents in Kuje and Abaji were all females,
there were equal male and female respondents in Kubwa and Robochi general
hospitals; and 38%Male and 62%Female Respondents at Wuse District Hospital.
In summary, 32% of the total 50 Respondents were female while 68% were male.
The researcher did not identify any possible implication of this composition on the
integrity of the data obtained from them.
Years in Service
n=50
n%
1-2yrs
14%
3-4yrs
11
22%
5-6yrs
23
46%
7-8yrs
16%
9 & Above
2%
25
From Table 4.2 and Fig. 4.1, 14% 0f the respondents have worked in their
respective facility for a period of between 1 and 2 years while 23 of them,
representing 46% have worked for between 5-6years. 8 of them have worked for
between 7-8years while only 1 respondent have worked for more than 9years. The
above data suggest that a majority of the respondents have substantial level of
experience in their given responsibilities in the IDSR programme as HIM
professionals.
26
n%
level
1. IDRS Form 001
12
100
12
100
12
100
4. Outpatient Register
12
100
5. Inpatient Register
12
100
6. HMIS
12
100
7. Stationery
12
100
8. Calculator
12
100
9. Computers + Internet
42
10. Printers
12
100
11. Telephone
42
Table 4.3: Availability of materials and Resources for IDSR Programme at the 12 Healthcare
facilities.
The above table lists the various forms and other tools which are often
provided for the smooth running of the IDSR system in the various healthcare
facilities. Table4.3 above shows that the 12 General or District hospitals all have
IDSR forms 001, 002 & 003. They all equally have Outpatient & Inpatient
registers as well as stationeries, calculators and printers, representing one hundred
percent of availability. This contrasts a little with results of Abubakar, et al, (2013)
27
who reported that sixty-two percent of health facilities in Kaduna State had
calculators available for Data management, while twenty-nine percent of them had
computers and printers.
However, only 5 of them respectively have Computers + Internet services
and constant power supply but all of them have the Hospital Management
Information System (HMIS) in booklet form, but all lack telephone network for the
IDSR programme. The implication of these is that the hospitals have almost all the
necessary materials and resources needed to contribute meaningfully to the smooth
running of the system.
4.2.4 Knowledge of the IDSR System by the HIM professionals
Knowledge of the IDSR system by the HIM professionals
Awareness of the IDSR system in your facility:
Yes
No
n=50 n%
48
2
96
4
Table 4.4: Number of HIM professionals who are aware of the existence of the IDSR system in
their facilities.
Fig.4.2: Bar showing the Awareness of HIM professionals of the existence of the IDSR system
in their respective facilities.
28
n=50* n%
i.
84
ii.
correctly mentioned
Immediate/Case-based Notification & 1 Disease 46
92
correctly mentioned
Immediate/Case-based Notification only
2 diseases correctly mentioned only
1disease only correctly mentioned
Do not know
No response
46
22
6
2
4
iii.
iv.
v.
vi.
vii.
23
11
3
1
2
Table 4.5a: Knowledge of the use of the IDSR form 001. *there were multiple responses.
29
n=50* n%
Epidemic-prone 42
84
92
iii.
iv.
v.
vi.
vii.
diseases only
2 diseases correctly mentioned
1 disease correctly mentioned
Do not know
No response
Epidemic-prone 23
46
11
3
1
2
22
6
2
4
Table4.5b shows the knowledge of the respondents of the use of the IDSR
Form 002. This knowledge shows a similar pattern of their knowledge of Form001.
Knowledge of IDSR 003 Forms for :
n=50*
i.
Routine monthly disease notification & 2 diseases correctly 9
ii.
mentioned
Routine monthly disease notification & 1 disease correctly 11
mentioned
iii.
Routine monthly disease notification only
iv.
2 diseases correctly mentioned
v.
Only 1 disease correctly mentioned
vi.
Do not know
vii.
No response
Table 4.5c: Knowledge of IDSR Form 003. *Multiple Responses.
23
31
43
5
2
n%
18
22
46
62
86
10
4
7
13
47
43
47
47
14
26
94
86
94
94
32
vii.
viii.
ix.
x.
xi.
xii.
7
6
11
7
1
2
14
12
22
14
2
4
Table 4.6: Knowledge about the Use of IDSR Records at the facility level. *Multiple Responses.
Fig.4.6: Knowledge about the Use of IDSR Records at the facility level.
Table4.6 and Fig.4.6 show the number and percentage of the sampled HIM
professionals who are able to identify the various uses of the DSN Records. The
diagrams show that only (7)14% of them know that the DSN Records can be used
to know trends in disease occurrence, to initiate & monitor interventions and to
determine the prevalence of diseases, respectively; (13)26% of them know that the
records are used for disease prevention & control; but nearly all of them i.e.
(47)94% know that the records can be used for Statistics & Planning and same
number also know they can be used for Record or reference purposes and for
Research purposes, respectively. A majority of them (43)86% also know that the
33
records can be used to detect & notify disease outbreaks. However, only a very few
of them, (6)12% and (11)22% know that the records can be used for reporting to
DSNO & other authorities and for Health Education & Advocacy respectively. It is
worthwhile to equally note that only (1)2% of the respondents conceded not to
know what the records are used for while (2)4% people had no response to the
issue.
4.2.7 Assessment of the Attitudes of Respondents towards the IDSR
system.
This section would deal with the assessment of the attitudinal pre-disposition of
the respondent HIM professionals towards the IDSR system. Measuring attitudes is
a part of the standard KAP survey questionnaire administered to the respondents.
The section would analyze the personnels responses which would indicate their
prevailing tendencies to respond favorably or unfavorably to the IDSR system.
v.
vi.
vii.
objectives in Abuja.
Believe in the programme.
Do not believe in the programme
Indifference
No Response
n=50*
5
16
23
n%
10
32
46
43
1
4
2
86
2
8
4
Table4.7 and Fig.4.7 give great insight into the attitudes of the respondent
HIM professionals towards the Integrated Disease Surveillance and Response
34
(IDSR) programme. The diagrams show that only (5)10% of the respondents said
they attach great importance to the IDSR System; (16)32% feel that the IDSR is a
programme that should be embraced & encouraged; (23)46% of them are
optimistic that IDSR would achieve its stated aims & objectives in Abuja.
While almost all the respondents i.e. (43)86% believe in the programme, only
(1)2% of them do not believe in the programme. However, (2)4% respondents did
not respond to the issue and (4)8% claimed indifferent to the programme.
4.2.8 Assessment of Practice of HIM professionals in core functions
35
others. The respondents were assessed based on the practices which are relevant to
their roles and responsibilities in the IDSR programme, (see Table4.8 & Fig.4.8).
Some core surveillance Practice
i.
Ability to correctly complete Inpatient Register
ii.
Ability to correctly complete Outpatient Register
iii. Ability to summarize & present data in tables
iv.
Ability to perform Trend Analysis
v.
Ability to calculate Incidence & Prevalence of Diseases
vi.
Ability to compare present & previous data
vii. Not able to do any
viii. No Response.
n=50
48
48
23
7
23
7
0
2
n%
96
96
46
14
46
14
0
4
Table4.8 and Fig.4.8 show the practical abilities of the respondent HIM
professionals to perform some of the core functions in the IDSR system. The
diagrams show that almost of them i.e. (48)96% were able to correctly complete
36
both the Inpatient and Outpatient registers; but just (23)46% of them were able to
summarize & present data in tables and similar number were able to calculate
Incidence & Prevalence of Diseases; (7)14% could perform Trend Analysis and
same number said they were able to compare present & previous data. A more
cheery revelation was that none accepted not to be able to perform any one of the
core surveillance functions in their health facilities.
5.2 Recommendations
38
References
39
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attitudes and practices? Some observations from medical anthropology research on
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Finland.
3. Balshem, M. (1993): Cancer in the community: Class and medical authority. Smithson
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of Reporting of Notifiable Diseases Among Health Workers in Yobe State, Nigeria.
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List of Tables
1. Table3. 1: Number of HIM Professionals drawn from each facility following Proportional
Allocation.
2.
5. Table 4.4: Number of HIM professionals who are aware of the existence of the IDSR
system in their facilities.
43
IDSR.
List of figures
1. Fig. 3.1: Chart showing the number of HIM Professionals drawn from each hospital by
proportional allocation.
2. Fig. 4.1: Years of working experience of the respondents in pie chart.
3. Fig.4.2: Bar showing the Awareness of HIM professionals of the existence of the IDSR
system in their respective facilities.
4. Fig. 4.5a: Knowledge of the use of the IDSR forms 001.
5. Fig. 4.5b: Knowledge of the use of the IDSR forms 003
6. Fig.4.6: Knowledge about the Use of IDSR Records at the facility level.
7. Fig.4.7: Attitudes of Respondents towards the IDSR.
8. Fig.4.8: Assessment of Practice of HIM professionals in core functions of the IDSR.
Appendix
QUESTIONNAIRE
Dear respondent,
44
This questionnaire is to collect data for a study in Knowledge, Attitude and Practice of
Health Information Management (HIM) professionals towards Integrated Disease Surveillance
and Response (IDSR) in Abuja, Nigeria: a case study of 12 Hospitals in FCT, Abuja, Nigeria.
Please answer the questions to enable me successfully complete the project. Every
information volunteered will be purely for academic purpose and shall be strictly confidential.
Thanks for your cooperation.
Section A: Bio-data of respondents.
Please write in or tick X on the appropriate box.
1. Age in years:
(a) <20 ( ), (b) 21-30 ( ), (c) 31-40 ( ), (d) 41-50 ( ), (e) > 51( ).
2. Gender: Male ( ) Female ( ).
3. Designation:
4. Number of years in service (in years):
(a) 1-2 ( ), (b) 3-4 ( ), (c) 5-6 ( ), (d) 7-8 ( ) (e) 9 & above ( ).
Available
Non-Available
45
11
12
Telephone
Constant power supply.
No
hospital.
B
No
following:
Yes
1. Immediate/case-based notification & 2
diseases correctly mentioned
2. Immediate/case-based notification & 1
disease correctly mentioned
3. Immediate/case-based notification
4. 2 diseases correctly mentioned only
5. Only 1 disease correctly mentioned
6. Do not know any of its use
C
I know Form 002 is used for the
following:
s
1. Weekly notification of new cases of
Ye
N
o
No
No
authorities
8. For health education & advocacy
9. For research purpose
10. To determine the prevalence of disease
11. I do not know any of its use
Section D: Attitude of HIM professionals towards the IDSR programme
Please tick as appropriate.
S/n Attitudes
Yes
1
I attach great importance to the IDSR
2
system
IDSR is a programme to be embraced &
encouraged
I am optimistic that IDSR would achieve
4.
5.
No
47
register
Ability to correctly complete outpatient
register
Ability to summarize & present data in
4
5
Prevalence of diseases
Ability to compare present & previous
Un-able to perform
&
data
48