Baseline assessment of front-line health system capacity in vector-borne disease surveillance and response in Papua New Guinea.

Abstract

International public health surveillance and timely response cannot exist without strengthened local surveillance and response systems. Supporting front-line healthcare workers to embed the use of innovative electronic health information systems into adaptable and sustainable processes within their contexts is essential for response to ongoing vector-borne diseases (VBDs) and emerging infectious diseases in resource-constrained settings such as Papua New Guinea (PNG). Baseline health service assessments were conducted at eight provinces to inform the implementation of the STRIVE-Tupaia platform. The STRIVE-Tupaia platform is an innovative electronic real-time data aggregation platform in PNG where healthcare workers are able to review, interpret and respond to febrile illness, molecular diagnostic and vector surveillance data to support evidence-based decision making. Baseline health service assessments involved semi-structured interviews and structured observations of facility procedures. Quantitative data were analyzed using Microsoft Excel, while the qualitative data were thematically coded in NVivo12 (QSR International Pty Ltd). A deductive analysis focussed on the health systems barriers and enablers using the WHO's seven component health systems framework. An inductive analysis explored these impacts for vector-borne disease services specifically. Results indicated barriers to VBD reporting, notification and response including limited training, infrastructure challenges, overstretched workforce and limited governance support. Key learnings from STRIVE's baseline health facility assessments have been used to inform the implementation of the STRIVE-Tupaia platform and improve health care workers routine reporting, notification and response to vector-borne diseases in Papua New Guinea.