Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative study

Objective To explore the experiences and perceptions of health system stakeholders of a rural district of Sindh, Pakistan regarding the barriers to effective surveillance of communicable diseases.Design This qualitative descriptive exploratory design comprised in-depth interviews. Both inductive and...

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Main Authors: Sameen Siddiqi, Amna Rehana Siddiqui, Rumina Hasan, Imran Naeem
Format: Article
Language:English
Published: BMJ Publishing Group 2022-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/11/e067031.full
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author Sameen Siddiqi
Amna Rehana Siddiqui
Rumina Hasan
Imran Naeem
author_facet Sameen Siddiqi
Amna Rehana Siddiqui
Rumina Hasan
Imran Naeem
author_sort Sameen Siddiqi
collection DOAJ
description Objective To explore the experiences and perceptions of health system stakeholders of a rural district of Sindh, Pakistan regarding the barriers to effective surveillance of communicable diseases.Design This qualitative descriptive exploratory design comprised in-depth interviews. Both inductive and deductive thematic analysis was applied to identify key themes from the data.Settings The study was conducted in public sector healthcare facilities and the district health office of the rural district of Thatta, in Sindh province, Pakistan.Participants Fifteen healthcare managers and healthcare providers working in the eight public sector primary and secondary healthcare facilities were interviewed using an open-ended in-depth interview guide.Results Key themes that emerged from the data were: poor governance and absence of surveillance policy framework; fragmentation in the health system leading to lack of uniform reporting; inadequate (human) resources that weakened the infrastructure for disease surveillance; hospital-based reporting of cases that led to a predominantly passive surveillance system; paper-based surveillance system as the key determinant of delayed reporting; non-utilisation of surveillance data for decision making; absence of local laboratory capacity to complement the detection of disease outbreaks and lack of private sector integration in disease surveillance.Conclusions Poor governance and lack of policy framework were perceived to be responsible for weak surveillance infrastructure. Resource deficiencies including inadequate human resource, paper-based reporting and the absence of local laboratory capacity were considered to result in delayed, poor quality and incomplete reporting. The lack of private sector engagement was identified as a major gap.
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spelling doaj.art-8224b9a46bf5472ba83db33b0f6a020e2022-12-22T03:39:13ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-067031Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative studySameen Siddiqi0Amna Rehana Siddiqui1Rumina Hasan2Imran Naeem3Department of Community Health Sciences, Aga Khan University, Karachi, PakistanDepartment of Community Health Sciences, Aga Khan University, Karachi, PakistanDepartment of Pathology & Laboratory Medicine, Aga Khan University Hospital, Karachi, PakistanDepartment of Community Health Sciences, Aga Khan University, Karachi, PakistanObjective To explore the experiences and perceptions of health system stakeholders of a rural district of Sindh, Pakistan regarding the barriers to effective surveillance of communicable diseases.Design This qualitative descriptive exploratory design comprised in-depth interviews. Both inductive and deductive thematic analysis was applied to identify key themes from the data.Settings The study was conducted in public sector healthcare facilities and the district health office of the rural district of Thatta, in Sindh province, Pakistan.Participants Fifteen healthcare managers and healthcare providers working in the eight public sector primary and secondary healthcare facilities were interviewed using an open-ended in-depth interview guide.Results Key themes that emerged from the data were: poor governance and absence of surveillance policy framework; fragmentation in the health system leading to lack of uniform reporting; inadequate (human) resources that weakened the infrastructure for disease surveillance; hospital-based reporting of cases that led to a predominantly passive surveillance system; paper-based surveillance system as the key determinant of delayed reporting; non-utilisation of surveillance data for decision making; absence of local laboratory capacity to complement the detection of disease outbreaks and lack of private sector integration in disease surveillance.Conclusions Poor governance and lack of policy framework were perceived to be responsible for weak surveillance infrastructure. Resource deficiencies including inadequate human resource, paper-based reporting and the absence of local laboratory capacity were considered to result in delayed, poor quality and incomplete reporting. The lack of private sector engagement was identified as a major gap.https://bmjopen.bmj.com/content/12/11/e067031.full
spellingShingle Sameen Siddiqi
Amna Rehana Siddiqui
Rumina Hasan
Imran Naeem
Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative study
BMJ Open
title Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative study
title_full Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative study
title_fullStr Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative study
title_full_unstemmed Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative study
title_short Exploring stakeholders’ experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of Pakistan: a qualitative study
title_sort exploring stakeholders experiences and perceptions regarding barriers to effective surveillance of communicable diseases in a rural district of pakistan a qualitative study
url https://bmjopen.bmj.com/content/12/11/e067031.full
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