Implementing Surveillance and Outbreak Response Management and Analysis System (SORMAS) for Public Health in West Africa- Lessons Learnt and Future Direction

Abstract

Background: Mobile devices have the potential to strengthen surveillance in sub-Saharan Africa. Electronic surveillance (eSurveillance) is the use of electronic systems to facilitate public health surveillance. Mobile health (mHealth) is the use of mobile phone technology for health-related purposes. SORMAS is a new system developed as a tool for surveillance and public health response management of infectious diseases. Aims: To pilot a new mobile phone based Surveillance and Outbreak Management and Analysis System (SORMAS) application in Nigeria and document the experience and challenges. Place and Duration of Study: Health facilities and Local Government areas in Kano and Oyo States, Nigeria, West Africa and Abuja, Nigeria, West Africa between December 2014 and July 2015. Methodology: The development of the tool included contributions from six organisations in three different countries. Experience with the management of the prior Ebola Virus Disease outbreak in the country served as blueprint for tool design. We used the Integrated Disease Surveillance and Reporting system as reference for the data model. SORMAS was piloted in over 60 health facilities of 16 Local Government Areas (LGA) in Oyo and Kano States. We analysed meeting reports training evaluations and supervisory visits to describe the process and identify challenges.  Results: It took 8 months from initiation to piloting of the newly developed tool. The process was characterized by early involvement of stakeholders in the design process, adherence to existing workflows and data standards and systematic evaluation of training and piloting. Challenges included user friendly login procedures and geographic separation of team members. Conclusion: Early involving authorities and other stakeholders is crucial for implementation of novel eHealth tools. The need for prior training and continuous supervisory availability on site should not be underestimated even for user friendly tools and it is preferable to have IT-programmers, content experts and future users work in geographic proximity to enhance exchange on needs and technical capabilities.