ASSESSMENT OF THE INTEGRATED DISEASE SURVEILLANCE AND RESPONSE IMPLEMENTATION IN SELECTED HEALTH FACILITIES OF SOUTHERN PROVINCE OF ZAMBIA.

Background: Disease Surveillance has been the cornerstone of public health decision making and practice world over. Monitoring of the progress of IDSR Strategy has been an important component to ensure its sustainability in Zambia. The aim of this paper was to reflect upon the experiences in the province in order to learn lessons and improve systems. Methods: A descriptive cross-sectional study design was used to assess the structures, core and support surveillance functions using a modified checklist from the WHO questionnaire. The purpose of the study was designed to gain more information through observations, descriptions and review of document aspects of the IDSR situation. All 13 districts, national and provincial offices, 77 facilities and 13 laboratories were assessed. Literature review studies were from PubMed and database of WHO and CDC from 31BC-2017 was under taken assessing communicable diseases surveillance systems. Results: The Public Health Act Cap 295 of the Laws of Zambia has inadequacies for effective implementation of modern required environment of IDSR. The findings revealed that despite significant progress made in overcoming the challenges identified, gaps still exist. The mixed challenges with core and support functions were observed. The issues identified included non-financing of IDSR activities, inadequate training and high turnover of peripheral staff, nonexistent of feedback from higher levels, inadequate supervision, weak laboratory capacities to diagnose dysentery, lack of Job Aids for laboratory staff. Transport and communication means were unavailable in rural facilities. The best out comes in the core functions and systems attribute were reported to levels when support surveillance functions performed well. The human resource was found to be an output determinant to IDSR apart from the technological and technical issues. Conclusion: Implementation of IDSR was associated with improved surveillance and response efforts. The challenges identified were largely ?systemic? in nature. However, nonexistent budgetary support from the monthly grants allocation erodes gains. Reviewed efforts from government and stakeholders are necessary to sustain and expand progress. Strengthening support surveillance functions alongside the six building blocks of the health care system at implementation levels remains cardinal.