Routine Monitoring of Surveillance Data

Monitoring: Routine and continuous tracking of the implementation of surveillance activities and of the overall performance of surveillance and response systems. Are we doing what we said we would do? Are we doing it well? • Evaluation: Periodic assessment of the relevance, effectiveness and impact of activities in the light of the objectives of the surveillance and response systems

Routine Monitoring of

Surveillance Data

Matt Moore, Resident Advisor Field Epidemiology Training Program

The surveillance cycle

Reporting / Data Collection

Analysis, Interpretation Action!

Evaluation

Diagnosis / Detection

Communicating Information

Monitoring: Learning Objectives

At the end of this session, you will be able to:

• Identify indicators and targets for a surveillance system

• Use indicators and targets to monitor the quality of surveillance

What are all of the steps that must take place for an individual case to be captured by national surveillance?

What are all of the steps that must take place for an individual case to be captured by national surveillance?

Person

develops

disease

Person seeks medical care

Person is evaluated (physical exam, lab tests)

Evaluation is done correctly

Case definition

is applied correctly

Case reported

by health facility to next level

Case is reported to national level

A problem in any part of the system can

create problems for the whole system

Monitoring is an important part of ensuring high-quality surveillance

For surveillance systems, what is the difference

between monitoring and evaluation ?

• Monitoring: Routine and continuous tracking of the implementation

of surveillance activities and of the overall performance of

surveillance and response systems

Are we doing what we said we would do?

Are we doing it well?

• Evaluation: Periodic assessment of the relevance, effectiveness and

impact of activities in the light of the objectives of the surveillance

and response systems

Is the surveillance system effective and useful?

If not, can it be improved so that it is effective and useful?

Indicators and Targets

Indicator

• Variables that can:

• Provide information regarding the

status of the system

• Be measured repeatedly over time

• Identify areas for improvement

• Must be interpreted in context of

other sources of information (e.g

supervisory reports)

• Example: Is reporting done on time?

Targets

• Goals that the system will try to achieve

• Should be ambitious but realistic

• Should be reviewed regularly

• Example: 80% of monthly reports are sent to the national level on time

What indicators could be used to monitor

performance?

Health Facility

Reporting Practices

District or Provincial Reporting Practices Disease Data

Laboratory Practices

Proportion of health

facilities submitting reports

on time to district or

province

Proportion of districts

or provinces submitting reports to next higher level within 2 days

Proportion of outbreaks notified to the next higher level within 2 days

Proportion of districts and provinces that report laboratory data

to the next higher level Proportion of health

facilities submitting

numbers of cases of

epidemic-prone diseases

Number of epidemics missed by district (detected by national level)

Proportion of confirmed outbreaks with a

recommended public health response

Proportion of provinces reporting laboratory data to national lab

Monitoring Exercise (10 minutes work,

10 minutes presentation/discussion)

Health

Facility Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

T/N (%)

(N-M)/N (%)

A L T T L L T T L L L L M

B T T T L T T T L T T T L

C M L L M L M L L M L T T

D T T T T T T T L T T L T

E L L L M T L M M L T L M

F T T T T T L L T T T L L

G T T T T T L T T T T T T

H M M M M M L L M L M M L

Questions

1 Calculate the timeliness of reporting for a health facility in the district

Record your answer in the second to last column, labeled T/N T means

on time and N means total number of reports

2 Calculate the completeness of reporting for a health facility and record

the answer in the last column, labeled (N-M)/N N means the total

number of reports and M means the number of reports missing/not

received

Then, as a group, please answer the following questions:

3 How many facilities reached the target of 80% timeliness?

4 Which health facility is the best in terms of timely reporting?

5 The target for completeness is 80% How many health facilities have

reached or passed the target?

Monitoring Exercise

• For the surveillance system that you will evaluate:

• What surveillance indicators are used?

• If you are not sure, what surveillance systems should be used?

• Monitoring is essential to maintain quality

• Established indicators are available for monitoring performance of

reporting sites

• Monitoring and evaluation should be used to develop strategies for

improvement of surveillance systems

Conclusion

C ả m n!