|Cerebrospinal Meningitis Epidemics and Surveillance Systems in the Sudan, Ethiopia and Chad (Centre for Research on the Epidemiology of Disasters, 1990, 40 p.)|
|II. COUNTRY REPORTS|
|B. People's Democratic Republic of Ethiopia|
|2. Referral and Surveillance Systems|
- The Department of Epidemiology
The Epidemiology Department is one of the 5 main health programme departments (see organigramme in annex 3)
The surveillance of communicable diseases as well as their control are amongst its responsibilities. This department has 9 divisions.
Important for epidemic control and surveillance are the Surveillance Division, the Epidemic Control Team, the Immunoprophylaxis Service and the administrative and logistics service.
The data are collected and compiled in the Surveillance Division.
- Monthly morbidity report
This system consists of the reporting of 150 diseases. Only cases are reported (and not deaths) by age group and sex. The number of vaccinations during the month are also reported on the same form.
There are two sources of data, the hospitals (88) and the out patient clinics.
It takes more or less three months before the reports reach the central level, and there is an important under-reporting of cases when compared to the weekly reporting system.
The data are compiled in the Surveillance Division and in the Health Statistics Division.
Data are compiled by hand.
- Weekly Notification of communicable diseases
This system covers the six EPI diseases plus meningitis, hepatitis, yellow fever, typhus, typhoid fever and diarrhoeal diseases. The data concern cases and deaths by age group and sex and origin. The delay before the information gets to the surveillance division is also long and estimated at around 3 months.
The reports are sent by all the health institutions to the Surveillance Division and to the Department of Epidemiology.
- Weekly radio - telephone communicable diseases report
There is a weekly radio or telephone communication with the different regions. The information reported is the same as that included in the weekly notification forms.
The communication network covers 25 of the 30 health regions. In each of these regions, only the main city has a telephone or a radio or both. It means that this rapid surveillance system is only effective for the major cities of the country and some regions are kept out entirely.
The data are compiled by hand.
Information on stocks is not reported.
The reporting system for refugee camp is separated, and there is not any formal report from NGOs
If an alarming message is received in the surveillance division, the epidemiology department is immediately informed.
The surveillance system is not very effective as soon as one leaves the regional level. The poor communication, the lacks of training of the health personnel at the peripheral level are the major reasons for this situation. In addition, as mentioned above, the health system covers only 60 % of the population.
There is not any feed-back information sent from the central level, except for PHC activities.
- Other surveillance systems in MOH
In 1987, CDD set-up a separate surveillance system partially sentinel based. There are 30 sentinel posts which are either regional hospitals, or health centres. Each sentinel post reports monthly.
The reporting is irregular and it takes sometimes more than a month before CDD gets the information. The reports are mailed to the central level and data are compiled by hand.
Nutritional surveillance is also a sentinel based system.