Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

Abstract Background Infectious diseases remain one of the greatest threats to public health globally. Effective public health surveillance systems are therefore needed to provide timely and accurate information for early detection and response. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2(DHIS2). As part of Global Health Security Agenda(GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates.Methods From February to May 2017, we analysed surveillance data for 13 intervention and 13 control counties. An intervention county was defined as one that had received a refresher training on DHIS2 while a control county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. A Likert scale was used to grade the challenges.Results The completeness of reporting increased after the training by 17 percentage points (from 45% to 62%) for the intervention group compared to 3 percentage points (49% to 52%) for the control group. Timeliness of reporting increased by 21 percentage points (from 30% to 51%) for the intervention group compared to 7 percentage points (from 31% to 38%) for the control group. Major challenges identified for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers being given other competing tasks.Conclusions Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.