Infectious disease outbreaks, such as the Ebola outbreak in West Africa, highlight the need for surveillance systems to quickly detect outbreaks and provide data to prevent future pandemics. The World Health Organization (WHO) developed the Joint External Evaluation (JEE) tool to conduct country-level assessments of surveillance capacity. However, considering that outbreaks begin and are first detected at the local level, national-level evaluations may fail to identify capacity improvements for outbreak detection. The gaps in local surveillance system processes illuminate a need for investment in on-the-ground surveillance improvements that may be lower cost than traditional surveillance improvement initiatives, such as enhanced training or strengthening data transfer mechanisms before building new laboratory facilities. To explore this premise, we developed a methodology for assessing surveillance systems with special attention to the local level and applied this methodology to the malaria outbreak surveillance system in Mashonaland East, Zimbabwe.
Objective: To conduct a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe.