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ISDS 2016 Conference Abstracts

Public Health Surveillance Strengthening in the 
Kingdom of Swaziland
Joy Sylvester1, Siphiwe Shongwe3, Vusie Lokotfwako*2, Nhlanhla Nhlabatsi2, 
Xolisile Dlamini5, Tony A. Trong4, Ruben Sahabo3, Affan Shaikh1, Paige Ryland1, 
Scott J. McNabb1 and Harriet Nuwagaba-Biribonwoha3
1Public Health Practice, LLC, Belmont, MA, USA; 2Epidemiology and Disease Control Unit, Swaziland Ministry of Health, Mbabane, 
Swaziland; 3ICAP at Columbia University, New York, NY, USA; 4U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA; 
5Swaziland Ministry of Health, Mbabane, Swaziland

Objective
To enable coordination of Swaziland Ministry of Health units for 

public health surveillance (PHS).

Introduction
In the Kingdom of Swaziland, a baseline assessment found that 

multiple functional units within the Ministry of Health (MoH) perform 
PHS activities. There is limited data sharing and coordination between 
units; roles and responsibilities are unclear. The Epidemiology and 
Disease Control Unit (EDCU) is mandated to coordinate efforts and 
strengthen PHS through implementing Integrated Disease Surveillance 
and Response (IDSR) to fulfill requirements of International Health 
Regulations (2005) (IHR[2005]), and the Global Health Security 
Agenda (GHSA).

Methods
A baseline assessment that included key informant interviews 

of unit representatives was conducted. Data flows were developed. 
Results were disseminated at a facilitated stakeholder workshop with 
unit representatives. A database was then built containing all distinct 
activities found within the IDSR Technical Guidelines (2010), IHR 
[2005], GHSA Action Packages, the baseline assessment, a previous 
CDC IDSR assessment, and suggestions from the stakeholder 
workshop. Activities were categorized by IDSR function (identify, 
report, analyze, investigate, prepare, respond, provide feedback, 
and evaluate) and designated as an ongoing “role” or a one-time 
implementation activity. A document containing all PHS roles was 
presented at a facilitated consensus workshop; unit representatives 
discussed and designated a lead unit/agency for each role.  
One-time implementation activities were assigned a lead actor, target 
completion date, and compiled into a 3-year IDSR Roadmap to guide 
implementation.

Results
A Roles and Responsibilities Framework was developed that 

presents a consensus on lead units for all roles within an IDSR-based 
PHS system that fulfills requirements of IHR [2005] and GHSA. 
This document enables coordination by EDCU. The IDSR Roadmap 
provides time-bound activities with assigned actors to implement 
IDSR. EDCU is using these documents to guide coordination of 
multiple MOH units already performing PHS activities.

Conclusions
Coordinating well-established programs that already collect 

epidemiological data increases efficiency and enables more complete 
epidemiologic analysis. Stakeholder engagement and clarity of roles 
is critical for EDCU to coordinate PHS. Consolidating activities 
for IDSR, IHR [2005], and GHSA in guiding documents enables a 
streamlined approach for public health surveillance strengthening. 
Future work aims to achieve data sharing through an electronic 

platform and introduce data standards for interoperability among data 
sets.

Keywords
IDSR; International Health Regulations; Global Health Security 
Agenda; Public Health Surveillance; Africa

Acknowledgments
Thanks to William MacWright.
This work is supported by the President’s Emergency Plan for AIDS 
Relief (PEPFAR) through the Centers for Disease Control and Prevention 
under the terms of Cooperative Agreement Number 1U2GGH001271.  
Its contents are solely the responsibility of the authors and do not 
necessarily represent the official views of PEPFAR or the Centers for 
Disease Control and Prevention

*Vusie Lokotfwako
E-mail: vusielokza@gmail.com

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e78, 2017