The World Health Organization (WHO) developed the Integrated Disease Surveillance and Response (IDSR) strategy that Nigeria has adopted since 2001 to enhance the preparedness for public health emergencies. This study examined the extent of implementation of the IDSR in Rivers State. A convergent mixed-method research design was employed. Structured questionnaires were used to collect the quantitative data from a cluster sample of 384 health workers from all 23 Local Government Areas in the state. Data were summarized and analyzed with descriptive and inferential statistics. Qualitative data was collected through in-depth interview of Disease Surveillance and Notification Officer, Health Records Officer and the surveillance focal persons. Thematic analysis was used and triangulation was applied. Quantitative data showed that there was a moderate to high level of adherence to IDSR protocols: familiarity with guidelines (mean = 3.82), the use of standardised reporting instruments (mean = 4.09), and adherence to outbreak response protocol (mean = 4.00). At the individual level compliance was high: reporting on time (mean = 4.18) and accuracy (mean = 4.59). Nevertheless, frequency of training (mean = 3.23), reception of feedback (mean = 3.36) and availability of resources (mean = 3.32) were inadequate These trends were supported by qualitative data which indicated that IDSR 002/ 003 forms were frequently used, learning was peer-to-peer instead of formal training, and highlighted logistic barriers. IDSR is weakly implemented in Rivers State. Lack of training, inconsistent feedback, and inadequate logistical support should be enhanced for equity in surveillance and responsiveness.
Pepple et al. (Tue,) studied this question.