Understanding mSOS: A qualitative study examining the implementation of a text-messaging outbreak alert system in rural Kenya

Outbreaks of epidemic diseases pose serious public health risks. To overcome the hurdlesof sub-optimal disease surveillance reporting from the health facilities to relevant authorities, the Ministry of Health in Kenya piloted mSOS (mobile SMS-based disease outbreak alert system) in 2013±2014. In this paper, we report the results of the qualitative study, which examined factors that influence the performances of mSOS implementation. In-depth interviews were conducted with 11 disease surveillance coordinators and 32 in-charges of ruralhealth facilities that took part in the mSOS intervention. Drawing from the framework analysis, dominant themes that emerged from the interviews are presented. All participantsvoiced their excitement in using mSOS. The results showed that the technology was wellaccepted, easy to use, and both health workers and managers unanimously recommended the scale-up of the system despite challenges encountered in the implementation processes.The most challenging components were the context in which mSOS was implemented, including the lack of strong existing structure for continuous support supervision,feedback and response action related to disease surveillance. The study revealed broader health systems issues that should be addressed prior to and during the intervention scaleup

Health worker knowledge of Integrated Disease Surveillance and Response standard case definitions: a cross-sectional survey at rural health facilities in Kenya

Background The correct knowledge of standard case definition is necessary for frontline health workers to diagnose suspected diseases across Africa. However, surveillance evaluations commonly assume this prerequisite. This study assessed the knowledge of case definitions for health workers and their supervisors for disease surveillance activities in rural Kenya. Methods A cross-sectional survey including 131 health workers and their 11 supervisors was undertaken in two counties in Kenya. Descriptive analysis was conducted to classify the correctness of knowledge into four categories for three tracer diseases (dysentery, measles, and dengue). We conducted a univariate and multivariable logistic regression analyses to explore factors influencing knowledge of the case definition for dysentery. Results Among supervisors, 81.8% knew the correct definition for dysentery, 27.3% for measles, and no correct responses were provided for dengue. Correct knowledge was observed for 50.4% of the health workers for dysentery, only 12.2% for measles, and none for dengue. Of 10 examined factors, the following were significantly associated with health workers’ correct knowledge of the case definition for dysentery: health workers’ cadre (aOR 2.71; 95% CI 1.20–6.12; p = 0.017), and display of case definition poster (aOR 2.24; 95% CI 1.01–4.98; p = 0.048). Health workers’ exposure to the surveillance refresher training, supportive supervision and guidelines were not significantly associated with the knowledge. Conclusion The correct knowledge of standard case definitions was sub-optimal among health workers and their supervisors, which is likely to impact the reliability of routine surveillance reports generated from health facilities.</p