Administrative Factors and Processes Affecting Performance of Epidemiological Surveillance among Health Personnel at Health Centers in Khammouane Province, Lao PDR / Lao Medical Journal

ABSTRACT

Rational and Background: Epidemiological surveillance by Khammouane Provincial Health Centers has been inadequate with incomplete and untimely data collection, and insufficient information dissemination. However, difficulties and gaps in the surveillance system have not been identified. Study of the administrative factors and processes affecting performance of epidemiological surveillance by health center workers would help to identify problems and therefore identify appropriate solutions. Methodology: This was a descriptive, cross-sectional study involving two groups: (1) 143 health workers from 74 health centers who were interviewed using a questionnaire and (2) 9 heads of epidemiology teams from 9 districts of Khammouane Provinces, Lao PDR who were interviewed in-depth. Results: Fifty-nine percent of the respondents were female with mean (SD) age of 35.6 (8.5) years. The mean (SD) years of working in epidemiology was 4.1 (4.2) years. The overall mean (SD) score of performance in epidemiological surveillance by the health center workers was 3.30/5 (0.94). The mean (SD) score of administrative factors affecting the performance in epidemiological surveillance was 2.68/5 (0.80). Previous training in epidemiology and educational level were positively correlated with epidemiology surveillance performance (r=0.25, P<0.05) and (r=0.27, P<0.05). Manpower, material, and budget were related with work performance (r=0.54, P<0.01), (r=0.34, P<0.01), and (r=0.22, P<0.01), respectively. In a multivariate analysis, planning (P<0.01), organization (P<0.01), and staff training (P<0.01) were independently correlated with the epidemiological surveillance performance. Conclusion: The level of the performance of epidemiological surveillance by Khammouan Health Center staff was moderately satisfactory. Regular monitoring of the work performance by the Provincial and District Health is required to identify problems and solutions. At least 1-2 workshops on epidemiological surveillance should be organized in order to enhance knowledge and understanding of disease surveillance by the health center staff aimed at improving their work performance.