Table_4_Implementation of DHIS2 for Disease Surveillance in Guinea: 2015–2020.docx

A robust epidemic-prone disease surveillance system is a critical component of public health infrastructure and supports compliance with the International Health Regulations (IHR). One digital health platform that has been implemented in numerous low- and middle-income countries is the District Health Information System Version 2 (DHIS2). In 2015, in the wake of the Ebola epidemic, the Ministry of Health in Guinea established a strategic plan to strengthen its surveillance system, including adoption of DHIS2 as a health information system that could also capture surveillance data. In 2017, the DHIS2 platform for disease surveillance was piloted in two regions, with the aim of ensuring the timely availability of quality surveillance data for better prevention, detection, and response to epidemic-prone diseases. The success of the pilot prompted the national roll-out of DHIS2 for weekly aggregate disease surveillance starting in January 2018. In 2019, the country started to also use the DHIS2 Tracker to capture individual cases of epidemic-prone diseases. As of February 2020, for aggregate data, the national average timeliness of reporting was 72.2%, and average completeness 98.5%; however, the proportion of individual case reports filed was overall low and varied widely between diseases. While substantial progress has been made in implementation of DHIS2 in Guinea for use in surveillance of epidemic-prone diseases, much remains to be done to ensure long-term sustainability of the system. This paper describes the implementation and outcomes of DHIS2 as a digital health platform for disease surveillance in Guinea between 2015 and early 2020, highlighting lessons learned and recommendations related to the processes of planning and adoption, pilot testing in two regions, and scale up to national level.

一个稳健的流行病易感性疾病监控系统是公共卫生基础设施的关键组成部分，并支持对国际卫生条例（IHR）的遵守。在众多低收入和中等收入国家中已得到实施的数字健康平台之一是区县级卫生信息系统版本2（DHIS2）。2015年，在埃博拉疫情之后，几内亚卫生部制定了一项战略计划，旨在加强其监控系统，包括采用DHIS2作为能够捕获监控数据的卫生信息系统。2017年，在两个地区对DHIS2疾病监控系统进行了试点，旨在确保及时提供高质量的监控数据，以更好地预防、检测和对流行病易感性疾病做出反应。试点的成功促使从2018年1月开始在全国范围内推广DHIS2进行每周汇总疾病监控。2019年，该国开始使用DHIS2追踪器来捕获流行病易感性疾病的个别病例。截至2020年2月，对于汇总数据，国家平均报告及时性为72.2%，平均完整性为98.5%；然而，个别病例报告的比例总体较低，且在不同疾病之间差异很大。尽管在几内亚实施DHIS2用于流行病易感性疾病监控方面取得了实质性进展，但为确保系统的长期可持续性，仍有许多工作要做。本文描述了2015年至2020年初几内亚作为数字健康平台用于疾病监控的DHIS2的实施和结果，重点介绍了有关规划与采纳过程、两个地区的试点测试以及扩大至国家层面的经验教训和推荐。