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Role of Primary Care Providers and Integrated Disease Surveillance in Chad Dhoud Stave Gischel Samba Walden University

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Role of Primary Care Providers and Integrated Disease Surveillance in Chad Dhoud Stave Gischel Samba Walden University Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2019 Role of Primary Care Providers and Integrated Disease Surveillance in Chad Dhoud Stave Gischel Samba Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Dhoud S. Samba has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Srikanta Banerjee, Committee Chairperson, Public Health Faculty Dr. Phuong Trang Huynh, Committee Member, Public Health Faculty Dr. Mountasser Kadrie, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2019 Abstract Role of Primary Care Providers and Integrated Disease Surveillance in Chad by Dhoud S. Samba MPH, Walden University, 2011 BA, Erskine College, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University July 2019 Abstract In the Republic of Chad, primary care physicians play a central role in the detection and control of outbreaks and are critical actors in the integrated disease surveillance system through mandatory reporting. Feedback on such surveillance must reveal the needs and perceptions of these physicians. These needs and perceptions were examined using a questionnaire survey distributed to a sampling of 20 physicians in Chad. The purpose of this qualitative study was to investigate the role of primary care providers in the integrated disease surveillance to identify factors that impact complete, quality, and timely reporting. The theory of planned behavior was used for the theoretical framework. Interview data collected from the physicians via a purposive sampling strategy were analyzed. The questionnaire used a standardized, validated tool to assess the role and factors that impact complete, quality, and timely reporting related to the integrated disease surveillance system among primary care physicians. Demographics and descriptive analysis of the frequency of responses was performed. Key findings were positive for the importance of the provider’s role in case detection and case reporting. These findings offer an understanding of factors that affect the complete, quality, and timely reporting and give insight into how the integrated disease surveillance system might be improved. The data show the physicians understood how to conduct disease reporting, and provide solutions for enhancing the integrated disease surveillance system. These findings support social change by informing the important practice of early detection and reporting of infectious diseases to detect and control future outbreaks. Role of Primary Care Providers and Integrated Disease Surveillance in Chad by Dhoud S. Samba MPH, Walden University, 2011 BA, Erskine College, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University July 2019 Table of Contents List of Tables ..................................................................................................................... vi List of Figures ................................................................................................................... vii Chapter 1: Introduction to the Study ....................................................................................1 Introduction ....................................................................................................................1 Study Background ..........................................................................................................4 Problem Statement .........................................................................................................7 Purpose of the Study ......................................................................................................8 Research Questions ........................................................................................................9 Theoretical Framework ..................................................................................................9 Nature of the Study ......................................................................................................10 Definition of Terms......................................................................................................11 Assumptions .................................................................................................................14 Limitations ...................................................................................................................14 Scope and Delimitations ..............................................................................................15 Summary ......................................................................................................................15 Chapter 2: Literature Review .............................................................................................17 Introduction ..................................................................................................................17 The IDSR Strategy of the WHO AFRO ......................................................................17 Literature Search Strategy............................................................................................19 Theoretical Foundation ................................................................................................20 Literature Review Related to Key Variables ...............................................................21 i Provider Knowledge of IDSR and Notification System ..............................................21 The WHO International Health Regulations ................................................................23 The National Notifiable Diseases Surveillance System ...............................................24 IDSR Implementation Structure in Chad .....................................................................25 Public Health Surveillance System in Chad ................................................................26 Reporting Structure in Chad ........................................................................................29 Active Versus Passive Surveillance of IDSR ..............................................................31 Studies Regarding IDSR Implementation ....................................................................33 Summary ......................................................................................................................42 Chapter 3: Research Method ..............................................................................................44 Introduction ..................................................................................................................44 Research Design and Rationale ...................................................................................44 Grounded Theory and Background ..............................................................................46 The Role of the Researcher ..........................................................................................49 Methodology ................................................................................................................50 Data Collection Process ...............................................................................................51 Study Population and Setting .......................................................................................53 Selection Criteria for Key Informant Participants .......................................................55 Key Informant Interview Protocol ...............................................................................57 Data Analysis Plan .......................................................................................................58 Threats to Validity .......................................................................................................60 Ethical Procedures .......................................................................................................61 ii Protection of Human Subjects .............................................................................. 61 Data Treatment.............................................................................................................62 Summary ......................................................................................................................62 Chapter 4: Results ..............................................................................................................64 Introduction ..................................................................................................................64 Study Setting ................................................................................................................65 Study Participants ........................................................................................................65
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