Strengthening Epidemic Control Policies through the Evaluation of Digital Disease Surveillance in Al Qadarif State’s Complex Emergency Settings
DOI:
https://doi.org/10.56147/jbhs.3.4.157Keywords:
- Health,
- Environment,
- Al Qadarif State,
- Epidemic control,
- Diseases,
- Emergency,
- Public health systems,
- Population
Abstract
Al Qadarif State, Sudan, faces a compounding crisis of population displacement from armed conflicts in both Sudan and Ethiopia, alongside seasonal flooding and recurrent epidemics. While digital health surveillance tools exist, a critical gap remains in translating raw epidemiological data into timely policies. This gap persists due to fragmented infrastructure, weak inter-agency data governance and siloed, non-interoperable systems. This mixed-methods study evaluated digital disease surveillance systems across three administrative levels to identify key operational, structural and governance barriers.
Guided by WHO evaluation guidelines, data collection was fully digitized using KoboToolbox. Using a purposive sampling strategy to target key digital health decision-makers and coordinators, the study evaluated 21 institutional stakeholders across state (57.14% (12/21)), locality (33.33%, (7/21)) and health facility (28.57% (6/21)) levels, spanning UN/INGOs (57.14% (12/21)), public health sectors (33.33% (7/21)) and local NGOs (19.05% (4/21)).
DHIS2 is the most utilized platform (47.62% (10/21)), followed by Excel (38.10% (8/21)) and voice/SMS reporting (38.10% (8/21)). However, 57.14% (12/21) of respondents reported poor infrastructure, resulting in 24-48-hour reporting delays. Database interoperability is severely limited, with (80.95% (17/21)) reporting only partial integration dependent on manual file transfers and (47.62% (10/21)) stating that existing systems fall below standard for tracking highly fluid, displaced populations. The most prominent threat to data quality is an acute shortage of trained personnel and digital competencies ((80.95% (17/21)), followed by device destruction (52.38% (11/21)) and insecurity-driven under-reporting (52.38\%$ (11/21)). Primary policy translation barriers include a lack of dedicated, flexible emergency funding (85.71% (18/21)), environmental obstacles like blocked roads (76.19% (16/21)) and absent data-sharing policies paired with security restrictions (52.38% (11/21) each).
Despite frontline resilience, Al Qadarif’s digital surveillance is severely bottlenecked. To bridge the gap between digital data and rapid epidemic response, stakeholders prioritize three critical interventions: continuous digital and emergency training for frontline staff, deploying alternative energy systems alongside offline-capable, auto-syncing digital tools and building unified cross-agency dashboards, supported by formalized emergency data-sharing frameworks.
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