1) The study analyzed weekly surveillance reporting in Kabarole District, Uganda from November 2019 to January 2020 and found that timeliness of reporting was 32% and completeness was 63%, below the target of 80%. 2) Analysis of 12 health facilities selected for the study found variability in timeliness of reporting, ranging from 11% to 92% among facilities. 3) Review of reported cases of dysentery, measles and typhoid fever over the period showed fluctuating numbers but typhoid fever cases exceeded the action threshold of 20 cases in multiple weeks, though facilities were using non-recommended diagnostic tests. 4) Recommendations included intensifying support supervision to improve reporting, sensitizing on recommended diagnostic

1. Weekly HMIS Reporting in KABAROLE DISTRICT,
Nov 2019-Jan 2020
Dr Mathias Tumwebaze
AFENET MEETING -OXFORD HOTEL MBARARA
8th March 2020

2. Presentation outline
• Kabarole district profile
• Introduction
• objectives
• Methods
• Findings
• Conclusions & Recommendations
• Acknowledgment

3. District profile
• Kabarole district made up of 2
counties ( 2HSDs)
• Has 22 s/counties , 59 parishes
and 523 villages
• Population of 328,500 : annual
growth rate of 2.3%
• Health infrastructure: 4 hospitals,
2 HC IVs, 23 HC 111s & 24 HC11s
T=53 Health Centre's

4. Introduction
• FETP-Frontline training requirement for completion is attendance of all
workshops and complete two field placements
– analysis of weekly surveillance reporting
– Data quality assessment
• Analysis focussed on 2 indicators (Timeliness and completeness ) of HMIS
033b for 6 Epi weeks (WK 44- 49) in 2019
• FETP – placement 11 was meant for me to do expanded surveillance for
more 6 weeks in all health facilities but also narrow down to 12 selected
H/Facilities facilities.

5. Objectives
1. To conduct further analysis of weekly surveillance reporting for
all 53 Health facilities in the 12 epi weeks.
2. To establish the district performance in Timeliness and
Completeness of weekly reporting (HMIS 033b)
3. To find out improvements made in reporting indicators among the
12 selected FETP-project sites in Kabarole.
4. Do trend analysis of 3 frequently reported epidemic prone
disease during the 12 weeks of assessment

6. Methods
Reviewed Data in DHIS 2 on weekly reporting for all 53Health facilities
Focussing on 2 indicators:- Timeliness= T and Completeness =C
Then extracted weekly data (HMIS 033b) of 12 Health Facilities selected as
field project sites for the 4 FETP-Frontline participants in Kabarole
Using Microsoft excel program , Timeliness and Completeness - Computed.
For all 53 H/Fs and for the 12 Project Health Facilities
Identification of 3 most reported epidemic diseases and do trend analysis

7. Table 1: KABAROLE DISTRICT HMISO33b WEEKLY REPORTING STATUS (WK 44 2019--WK 32020
Reporting status
Wk
44
Wk
45
Wk
46
Wk
47
Wk
48
Wk
49
Wk
50
Wk
51
Wk
52
Wk
01
Wk
02
Wk
03
Total reports
expected in week 53 53 53 53 53 53 53 53 53 53 53 53
Total reports
received in week 38 37 43 44 37 42 44 28 26 21 34 30
Total reports on
time by week 17 22 19 22 15 23 19 18 15 12 12 9
% completeness 72 70 81 83 70 79 83 53 49 40 64 57
% Timeliness 32 42 36 42 28 43 36 34 28 23 23 17

8. Figure1: Kabarole HMIS 033b weekly reporting status expected
reports, received & Reports on time
W44 W45 W46 W47 W48 W49 W50 W51 W52 W1 W2 W3
53 53 53 53 53 53 53 53 53 53 53 53
38 37
43 44
37
42
44
28
26
21
34
30
17
22
19
22
15
23
19 18
15
12 12
9
Total expected in wk Total reported in wk Total reports on time

9. Findings :
Expanded surveillance activity- weekly reporting
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
W44 2019 W45 2019 W46 2019 W47 2019 W48 2019 W49 2019 W50 2019 W51 2019 W52 2020 Wk1 2020 Wk2 2020 Wk3 2020
Complete 70% 70% 81% 82% 70% 79% 83% 53% 49% 49% 64% 57%
Timely 32% 42% 36% 42% 29% 43% 46% 34% 28% 23% 23% 17%
Percent
KABAROLE DISTRICT WEEKLY REPORT TIMELINESS AND COMPLETENESS WK 44-WK 3(2019-2020)
Target 80% Timeliness & completeness
T= 32%
C--= 63%

10. Table 2: Kabarole weekly reporting pattern of the 12
FETP Health Facilities wk 44-2019-wk 3 (2020)
Health Facility W44 2019 W45 2019
W46
2019
W47
2019
W48
2019 W49 2019 W50 2019 W51 2019
W52
2019
W1
2020
W2
2020
this wk
3 2020
% cumulative
Timeliness
Bukuku HC IV T T L T L T L NR NR NR NR T 63%
Fort Portal Police
HC II NR T T T T T T T NR L L L 64%
Kataraka HC IV T T T T T T T T L T T T 92%
Katojo HC3
Prisons HC T T T T T T T T L NR T L 82%
Kicwamba HC III L NR L L L L T NR L NR T NR 25%
Kijura HC III L L L L NR L L NR NR L L T 11%
Mucwa HC III L NR L L NR L T NR NR T NR NR 14%
Mugusu HC3 T L L T L L L L NR NR NR L 22%
Muhooti HC 11
Baracks L NR NR L L L L T NR NR NR NR 17%
Kabende HC3 L L L T L NR L NR T NR NR L 25%
Kasenda HC3 T T T T T T T L NR T L NR 89%
Ruteete HC III T L T L L T T T T NR T L 55%
L
L

11. Trend of Dysentery, Measles & Typhoid fever in Kabarole
wk 44 (2019–wk 3 (2020
W44 W45 W46 W47 W48 W49 W50 W51 W52 W1 W2 W3
Dysentery Cases 12 8 3 5 1 3 0 1 3 0 3 1
Measles Cases 1 0 1 0 0 1 0 0 1 0 0 0
Typhoid Fever Cases 15 13 25 29 20 17 15 2 8 12 12 13
0
5
10
15
20
25
30
35
Noofcases
Weekly trend of 3 priority IRDs(Dysentery, Measles and Typhoid fever)

12. weekly trend of Typhoid fever, the Action threshold levels surpassed
0
5
10
15
20
25
30
35
W44W45W46W47W48 W49W50W51W52 W1 W2 W3
noofcases
Typhoid Fever Cases
Typhoid Fever Cases
Action Threhold:20 cases in
weeks
Interview of clinicians about Typhoid fever problem showed that , cases are diagnosed
using Widal test. WHO recommends diagnosis by a blood or stool culture . The observed
outbreak of typhoid fever in Kabarole could be hypothetical.

13. CONCLUSION
 Kabarole district is not meeting 80% Timeliness &
Completeness target for HMIS 033b reporting.
Currently T=32% C=63%
 Health facilities diagnose typhoid fever by Widal test instead of
doing blood or stool culture

14. Recommendations
• The district FETP-Frontline participants to intensify targeted support
supervision and mentorships of all health workers on HMIS reporting
• The FETP- Frontline Team from Kabarole to intensify sensitization of the
clinical & lab staff on diagnosis of enteric fevers by blood or stool culture.
• Procure from MOH guidelines on laboratory confirmation of typhoid fever
and distribute to all Health Facilities.
• The BIOSTATISTICIAN will intensify monthly feedback to reporting H/Fs

15. Acknowledgment
AFENET – Technical Support
CDC- For Financial Support