Factors associated with timeliness of submission of weekly epidemiological surveillance reports by health facilities in Kabarole District, Uganda

Abstract

Introduction. Timeliness of submission of weekly epidemiological surveillance reports (WESR) is one of the ways through which countries can detect and respond to epidemic-prone diseases. To achieve timeliness of submission of WESR, countries in Africa, particularly Uganda recruited, trained Health Management Information System (HMIS) focal persons and equipped health facilities with the resources. However, despite this effort, according to Nansikombi et al, timeliness of submission of reports remained at 49% far below the WHO targets of ≥ 80%. This study sought to establish the factors associated with timeliness of submission of WESR by health facilities in Kabarole district to generate evidence to guide action. Methods. A descriptive cross-sectional study design utilizing mixed methods of data collection was used. A total of 29 health facilities in Kabarole were included in the study. Data on their weekly reporting for the FY 2021/2022 was extracted from DHIS2 and analyzed using Microsoft excel software. HMIS-focal persons from 29 health facilities were interviewed using a structured questionnaire. Data was analyzed using Stata version 15 and results were presented using tables and graphs. A logistic model on individual HMIS focal personal factors associated with timeliness of submission of WESR was built using the step-wise strategy. Also, 14 key informant interviews were conducted among the facility in-charges and DHT members. Data was analyzed thematically using Atlas-ti software and results were presented in themes. Results: The study revealed that none of the health facility achieved the MHO target of 90% timeliness of submission of WESR during FY 2021/2022. However, using 75% for fair timeliness of submission of WESR, 31% of the health facilities in Kabarole district had fair timeliness of submission of WESR. Factors associated with fair timeliness of submission of WESR among HMIS focal persons were; positive attitudes (APR = 3.71, 95% CI: 1.13-1.21) and positive beliefs (APR = 8.62, 95% CI: 2.03-36.6). Having many HMIS staff, a sense of responsibility, use of text reminders and institutionalization of M-track digital platforms facilitated fair timeliness of submission of WESR. Conversely, lack of motivation, overwhelming workloads, poor telecom network and DHIS system breakdown dominated the barriers. Conclusion. None of the health facilities achieved 90% timeliness of submission of WESR in 2021/2022. HMIS focal personal attitudes and beliefs were associated with fair timeliness of submission of WESR. Institutional factors like use of text reminders and digital platforms facilitated fair timeliness of submission of WESR. The district officials should sensitize the HMIS focal persons to improve their attitude towards timeliness of submission of WESR.