WHO/EMC/ DIS/97.2

Protocol for the Evaluation of Epidemiological Surveillance Systems

World Health Organization Emerging and other Communicable Diseases, Surveillance and Control

This document has been downloaded from the WHO/EMC Web site. The original cover pages and lists of participants are not included. See http://www.who.int/emc for more information. © World Health Organization This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced and translated, in part or in whole, but not for sale nor for use in conjunction with commercial purposes.

The views expressed in documents by named authors are solely the responsibility of those authors. The mention of specific companies or specific manufacturers' products does no imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Protocol for the Evaluation of Epidemiological Surveillance Systems

Prepared for

Division of Health Situation and Trend Assessment and

Division of Emerging and other Communicable Diseases Surveillance and Control

by: Liverpool School of Tropical Medicine and Ministry of Health and Child Welfare, Government of Zimbabwe

1997 CONTENTS Page

Foreword

Part 1 ...... 1

1.1 Epidemiological surveillance systems ...... 2 1.2 Protocol for an evaluation ...... 4

Part 2 Preparation for the evaluation ...... 7

2.1 Initiation of the evaluation ...... 8 2.2 Defining the surveillance system ...... 9 2.3 Setting the terms of reference for the evaluation ...... 10 2.4 Preliminary organization of the evaluation ...... 12 2.5 Preparation of materials and schedules ...... 13

Part 3 Documentation and evaluation of the system ...... 17

3.1 Objectives of the system ...... 18 3.2 Population under surveillance ...... 19 3.3 Events under surveillance ...... 21 3.4 Flow diagram of the surveillance system ...... 24 3.5 Detection of events ...... 25 3.6 Reporting procedures ...... 27 3.7 Decision-making and action taken ...... 28 3.8 Feedback ...... 30 3.9 Resources available to the surveillance system ...... 31

Part 4 Evaluation of the capacity of the surveillance system ...... 33

4.1 Capacity of the system to monitor each event ...... 34 4.2 Overall capacity of the system ...... 36

Part 5 Outcome of the evaluation ...... 39

5.1 Making recommendations ...... 40 5.2 Presenting the findings and recommendations ...... 41 5.3 Implementing the recommendations ...... 42 5.4 Preparing the next evaluation ...... 43

Glossary

Related Documents

Evaluation of epidemiological surveillance systems February 1997 Foreword

The present document is not a “cookbook” on how to undertake surveillance. In the course of preparation and evaluation, the typical reader was perceived as the medical or health officer in a Ministry of Health or in a district who is asked to check how well the surveillance in his or her area is working (exactly such a description was made by a participant from Zimbabwe when the protocol was being tested in that country). The text is thus intended as a tool for the assessing an existing surveillance system and identifying areas which can be improved; it provides general advice on how to undertake these improvements.

The protocol was initially developed within WHO’s Division of Health Situation and Trend Assessment (HST) in 1994/1995. Some of the functions of this Division have since been taken over by the newly created Division of Emerging and other Communicable Diseases Surveillance and Control (EMC), and it was a logical step to continue this work within the new Division.

Many people contributed to the document; it is appropriate to acknowledge here the early work of Ms Sarah Macfarlane and colleagues, of the Liverpool School of Tropical Medicine, and of Dr Shiva Murugasamphillay and