2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Establishing a Plan of Action Implementing Integrated 
Disease Surveillance in Sudan
Hayat Khogali1, Ngozi A. Erondu*2, 4, Betiel H. Haile4 and Scott J. McNabb3, 4

1Sudan Federal Ministry of Health, Khartoum, Sudan; 2London School of Hygiene and Tropical Medicine, London, United Kingdom; 
3Emory University, Rollins School of Public Health, Atlanta, GA, USA; 4Public Health Practice, LLC, Atlanta, GA, USA

Objective
This presentation aims to discuss the need and share the results 

from an international, multi-disciplinary mission to assess public 
health surveillance (PHS) in Sudan and develop a plan of action 
(PoA) to strengthen PHS through integration. We will present the 
findings of the mission and the resulting PoA developed for Public 
Health Surveillance Strengthening (PHSS) designed to rapidly detect, 
report and respond to infectious diseases and establish sustainable, 
integrated One Health concepts.

Introduction
Integrated Disease Surveillance and Response (IDSR) is a strategy 

conceived and adopted by the World Health Organization Regional 
Office for Africa in 1998. The goal of IDSR is to support PHSS in 
Africa and enhance efficiency and communication across all levels of 
the national public health system. IDSR emphasizes the commitment 
of the revised International Health Regulations [IHR (2005)] to 
strengthen and maintain core capacities to detect, assess, report, and 
respond to public health events of international concern.

In February 2014, the Sudan Federal Ministry of Health (FMoH), 
requested an assessment of PHS with attention to PHSS integration 
opportunities and enhancing their ability to meet IHR (2005) 
requirements. A WHO Regional Office for the Eastern Mediterranean 
(WHO/EMRO) team of consultants performed this mission in 
collaboration with the FMoH.

Methods
The mission drew observations and conclusions and framed 

recommendations, derived from document reviews, semi-structured 
interviews with key informants, discussions with heads of disease-
specific programs and through observations on how PHS data were 
collected and reported from the peripheral levels to higher levels, as 
seen during the field visits. The findings of this technical mission and 
the recommendations were formulated into a country report and PoA.

Results
The mission found that PHS in Sudan consisted of multiple, siloed, 

vertical disease PHS systems, each using separate data collection and 
reporting paper-based forms. This resulted in duplication of data 
collection and inconsistencies in reported data from various sources. 
It also creates a burden on staff. A PoA to implement and sustain 
PHSS through integration in Sudan was developed and recommended 
to the Sudan FMoH. The PoA advocated a strategic approach of 
PHSS, which incorporated IHR (2005) and One Health concepts.

This PoA included technical, training, and management support 
services required to establish PHSS, e-Surveillance, and a Field 
Epidemiology Training Program (FETP) in Sudan. The main activities 
of this approach included:

• Facilitate coordination of national entities for One Health PHSS
with an objective of early warning and response

• Develop and modernize PHS tools, standards, guidelines and
policies, and streamline reporting channels

• Develop policies, and framework for national laboratory PHSS,
including standards and guidelines

• Train health and PHS officers on PHSS components
• Develop an FETP introduction plan

Conclusions
Empowering PHSS will equip a motivated health staff with a 

strategy to streamline PHS functions; coordinate an “all-hazards” 
monitoring and alert approach; and provide national consistency for 
detection, analyses, and reporting. If implemented, the recommended 
PoA supports a long-term goal to shift – in a phased manner – from 
the present fragmented, disease-specific, PHS focus, to an integrated 
one with full implementation capacity at the community, local, state, 
and national levels.

Keywords
IDSR; IHR(2005); Sudan; Plan of Action; One Health

Acknowledgments

The authors would like to greatly acknowledge the original mission 
members Dr. Hoda Mansour [HM] (NAMRU-3, Cairo) and Dr. Margaret 
Lamunu [ML] (WHO/HQ) as well as the support received from the CSR 
team of the WHO Coordinating Office and the Sudan FMoH.

References

McNabb, S.J.N., S. Chungong, M. Ryan, T. Wuhib, P. Nsubuga, W. 
Alemu, V. Carande-Kulis, and G. Rodier. Conceptual Framework of 
Public Health Surveillance and Action and its Application in Health 
Sector Reform. BMC Public Health 2002,2:2

McNabb, S.J.N., S. Chungong, M. Ryan, T. Wuhib, P. Nsubuga, W. 
Alemu, V. Carande-Kulis, and G. Rodier. Conceptual Framework of 
Public Health Surveillance and Action and its Application in Health 
Sector Reform. BMC Public Health 2002,2:2

Technical Guidelines for Integrated Disease and Response in the African 
Region (2nd Edition) October 2012

*Ngozi A. Erondu
E-mail: ngozierondu@gmail.com    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e32, 201