Assessment of the Integrated Communicable Disease Surveillance and Response System in Thamar Governorate, Yemen

Background: The Integrated Communicable Disease Surveillance and Response (IDSR) system facilitates detection, monitoring and the effective response to public health threats. Objectives: This study aimed to assess the IDSR system core and support functions in Thamar Governorate, Yemen. Methods: The study utilized a cross-sectional design. All health workers working in the IDSR system were interviewed (n = 212). The study included governorate, district and health facility levels of IDSR system. A specifically designed structured interview instrument was adapted from the WHO generic questionnaires. The questionnaire included two sections: assessment of core activities of the IDSR system (structure, case confirmation, data reporting, data analysis, outbreak investigation, epidemic preparedness, epidemic responses, feedback) and assessment of support functions of the IDSR system (supervision, training, coordination, logistics and resources). Results: Regarding case confirmation function, none of the health facilities had the capacity of specimen transport to a higher-level laboratory. Follow-up of specimen results, keeping of specimen results reports, and completion of specimen results reports were present in only 28.4%, 17.7%, and 17% of health facilities, respectively. Regarding data reporting function, a lack of recommended IDSR forms was reported in 46.1% of the health facilities and delayed submission of urgent notification for more than 24 hours was reported in 46.8% of health facilities. Regarding epidemic preparedness and response function, respondents at all health facilities revealed complete deficiency of emergency stocks of drugs and supplies, lack of budget line for epidemic response, and absence of community public health measures. Conclusion: There was a deficiency in case confirmation, data reporting, and epidemic preparedness and response activities of the core functions of IDSR system in all health facilities. The IDSR system demonstrated unacceptable performance at the health facility level, which represents the periphery of the system.