TITLE:
Evaluation of the Babies At Risk Surveillance System in Rushinga District, Mashonaland Central Province, Zimbabwe, 2015
AUTHORS:
Alice Kudzaishe Dzvukamanja, Cremance Tshuma, Donewell Bangure, More Mungati, Tsitsi Juru, Notion Tafara Gombe, Mufuta Tshimanga
KEYWORDS:
At Risk Babies, Cerebral Palsy, Surveillance, Rushinga District
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.5 No.4,
November
28,
2017
ABSTRACT: Background: About 15% of world’s population lives with some disability. Zimbabwe’s prevalence of disability was at 7% in 2013. ARSS is a paper-based system to monitor and detect neuro-developmental conditions and childhood disability early. Indicators for registering a baby into ARSS include: low Apgar score, low birth weight and birth asphyxia. Active case finding in Rushinga District in July 2015 identified nine cerebral palsy cases that were missed by the system out of 14 randomly chosen babies delivered at Chimhanda District Hospital. We evaluated the performance of the ARSS in Rushinga District. Methods: We evaluated the system using CDC guidelines for surveillance systems evaluation. All 12 health facilities in Rushinga were included. Health workers involved in ARSS were purposively recruited. Interviewer administered questionnaire, key informant interview guide, checklists and records review were used for data collection. Knowledge of participants on the system was assessed using five-point Likert scale. Data were analyzed using Epi Info 7. Results: Fifty-one participants were recruited for the study. Median years in service for all participants was 7 (Q1 = 6; Q3 = 12). Average knowledge score was 3. Majority participants (82.4%) were not trained on ARSS and cited lack of: knowledge, reporting guidelines, induction and focal persons as reasons for missing AR cases. Currently, ARSS is able to detect only 12.5% of cases. Prevalence of AR babies in Rushinga for period November 2014 to November 2015 was 21.1%. Monthly cost of detecting and registering a case was USD$52.46. Conclusions: ARSS was found to be useful, simple, acceptable and affordable, however was found to be unstable and not sensitive. Training of health workers particularly village health workers and integrating ARSS with the DHIS2 could improve system performance. As a result of the evidence from this evaluation, it has been agreed to include ARSS data on the monthly return form (T5) beginning June 2016.