The role of digital surveillance during outbreaks: the Ghana experience from COVID-19 response

Over the years, Ghana has made notable strides in adopting digital approaches to address societal challenges and meet demands. While the health sector, particularly the disease surveillance structure, has embraced digitization to enhance case detection, reporting, analysis, and informa-tion dissemination, critical aspects remain to be addressed. Although the Integrated Disease Surveillance and Response (IDSR) structure has experienced remarkable growth in digitization, certain areas require further attention as was observed during the COVID-19 pandemic. Ghana during the COVID-19 pandemic, recognized the importance of leveraging digital technologies to bolster the public health response. To this end, Ghana implemented various digital surveillance tools to combat the pandemic. These included the 'Surveillance Outbreak Response Management and Analysis System (SORMAS)', the digitalized health declaration form, ArcGIS Survey123, Talkwalker, 'Lightwave Health informa-tion Management System' (LHIMS), and the 'District Health Information Management System (DHIMS)'. These digital systems significantly contributed to the country's success in responding to the COVID-19 pandemic. One key area where digital systems have proved invaluable is in the timely produc-tion of daily COVID-19 situational updates. This task would have been arduous and delayed if reliant solely on paper-based forms, which hinder efficient reporting to other levels within the health system. By adopting these digital systems, Ghana has been able to overcome such challenges and provide up-to-date information for making informed public health decisions. This paper attempts to provide an extensive description of the digital systems currently employed to enhance Ghana's paper-based disease surveillance system in the context of its response to COVID-19. The article explores the strengths and challenges or limitations associated with these digital systems for responding to outbreaks, offering valuable lessons that can be learned from their implementation.