Effectiveness and Challenges of Public Health Surveillance and Disease Outbreaks Control in War Zones: A Case Study in South Darfur, 2023

Abstract

Public health surveillance in South Darfur relies on a combination of governmental and non-governmental efforts. However, the effectiveness of these systems is hampered by the lack of stable communication networks, inadequate data collection methods and the intermittent presence of health workers due to security concerns. Many health facilities have been damaged or destroyed and remain operational often lack essential medical supplies and adequately trained staff. This deterioration has undermined the region's ability to effectively monitor and respond to public health issues. This Study examines the specific challenges facing South Darfur state, Sudan, where effective disease outbreak response and Surveillance disrupted in late May 2023. The study followed the FMOH guidelines and tools. Structured discussions, observation and review of records and guidelines were done at state and localities levels. Quantitative data collected through a questionnaire of health care providers and community members in South Darfur, focusing on access to health care, disease prevalence and perceptions of surveillance effectiveness. Qualitative data collected through interviews with key stakeholders, including healthcare workers, humanitarian organizations and government officials, to provide nuanced insights into the challenges and strategies for managing disease outbreaks in war zones. Two hundred from Community volunteers and health workers from different levels were interviewed through google form. Director of Health Emergency and Epidemic Control, surveillance officers and focal persons for surveillance at the locality level were also interviewed. SPSS software was used to perform descriptive statistical analysis for quantitative data, while qualitative data was analyzed manually using thematic analysis, paying particular attention to the public health surveillance system level allowing for an exploration of effectiveness and challenges differ across levels to provide nuanced insights into the challenges and strategies for managing disease outbreaks in war zones. Written and verbal consents were obtained from all participants as appropriate.