Evaluation of the performance of the routine epidemiological surveillance system in the health district of tambacounda (senegal) in 2020

Introduction Epidemiological surveillance (ES) which is a continuous systematic process of data collection, analysis and interpretation for decision-making is of paramount importance for a good health system. Thus, to contribute to the improvement of the health system in Senegal, a study of the functioning of the routine epidemiological surveillance system was conducted in Tambacounda from S1 to S53 of the year 2020. Methodology A descriptive and analytical cross-sectional study was conducted from 1 to 17 July 2021. Comprehensive recruitment of the district’s 44 health care points was carried out. Data collection was carried out through a questionnaire prepared, pre-tested and administered to the 44 heads of public and non-public health facilities. The analyses were carried out with R software version 4.0.5. Results Of the 44 health facilities surveyed, 64% were public and 36% were non-public. The completeness and timeliness of the data were 100% and 97.5%, respectively. Suspected cases of tuberculosis were the most reported. For the providers surveyed (n=44), only 65.9% had knowledge of disease under epidemiological surveillance (DUES) and 93.2% managed suspected cases. On-site data analysis is only performed by 20.5% of providers. Only 38.6% of the service delivery point (SDP) had a health area card and the ES was under the responsibility of 77.3% of the paramedics. The training of ES officials was effective for only 45.5% of them. Despite the availability of dry tubes (69.8%), only 29.5% of PSD had COVID sampling equipment. The contribution of local authorities and technical and financial partners (TFP) to the SE was 22.7% and 29.5% respectively. There was a statistically significant link between public SDP with knowledge of DUES (p <0.001), display of case definitions (p <0.001), feedback of reported cases, knowledge of indicators (p<0.001), existence of a health area map (p <0.001), advocacy with authorities (p=0.003), staff training (p=0.002), availability of DUES vaccines (p <0.001), availability of notification form (p<0.001) and partner contribution to ES activities. Conclusion Staff training, regular monitoring of ES activities with greater involvement of non-public structures, and the availability of inputs applied to the six pillars of the health system, are essential elements on which action must be taken. for an efficient ES system in the Tambacounda health district for the benefit of the country’s health system. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was funded by the Ministry of Health and Social Action of Senegal. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: We have received administrative authorization from the Directorate of Planning, Research and Statistics of the Ministry of Health and Social Action to use data from the DHIS2 platform. The study received approval from the National Health Research Ethics Committee of Senegal (SEN/20/23) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All underlying data is available at * AFS : Administrative and Financial Service CMAC : Community Monitoring and Alert Committee CMO : Chief Medical Officer DCMO : Deputy Chief Medical Officer DHIS2 : District health information software DUES : Disease Under Epidemiological Surveillance EPI : Expanded Program on Immunization ES : Epidemiological surveillance ES FP : Epidemiological Surveillance Focal Point HCP : Home Care Provider HD : Health District HDC : Health Development Committee HN : Head Nurse IND : Immediately Notifiable Disease MoHSA : Ministry of Health and Social Action PHF : Public Health Facilities PSP : Problem-Solving Plan SDP : Service Delivery Point SM : State midwife TFP : Technical and financial partner TMP : Traditional Medicine Practitioners WHO : World Health Organization