Given South Sudan’s increased vulnerability to disease outbreaks and other public health threats, strengthening national disease surveillance and response and systems is crucial for early detection and rapid containment of disease outbreaks to help prevent needless illnesses and deaths.

To improve the functioning of the national surveillance system, the South Sudan Ministry of Health supported by the World Health Organization (WHO) with funding from the European Union Humanitarian Aid (ECHO) deployed a team of technical officers to five priority states. These states included Warrap, Lakes, Central Equatoria, Eastern Equatoria, and Unity. The teams conducted supportive supervision on the use of the Integrated Disease Surveillance and Response (IDSR) guidelines, job-aids, and reporting tools to ensure timely detection, investigation, and response to priority diseases, suspect outbreaks, and public health threats.

During the mission, the teams visited over 10 health facilities to assess the use of case definitions, electronic IDSR reporting using the Early Warning Alert and Response System (EWARS), and the use of other IDSR resources to improve surveillance and response performance. The teams also conducted on-the-job mentorship to identify and address health care workers’ performance.

Thanks to WHO, “the skills acquired and the IDSR tools provided have helped ease our work through improved reporting, alert verification and investigation, and response to disease outbreaks and other public health emergencies”, said Akier Akier, a surveillance officer in Gogrial West County, Warrap State.

“By using EWARS, the health facilities continue to submit their reports and we can initiate alert verification and investigations immediately with automated disease-specific alerts”, said Akier. “In November 2021, I managed to investigate nearly 10 alerts of acute flaccid paralysis and two suspect measles cases which were reported from the facilities through the EWARS system”.

“Since the rollout of training on the third edition IDSR guidelines, alert reporting in my State has improved by over 90 percent and so has timely investigation and response”, said John Akol Akol, Warrap state surveillance Officer. “Also, reporting of unusual health events such as flooding and snake bites by health facilities and community health workers has improved”.
Strengthening disease surveillance by adopting and implementing the IDSR strategy at all levels is one of the key priorities of WHO in South Sudan.   

Dr Fabian Ndenzako, the WHO Representative a.i. for South Sudan underscored the importance of strengthening stakeholder engagement and collaboration to enhance emergency response capacities in the country. “WHO will continue providing technical guidance to the Ministry of Health and partners to strengthen the national disease surveillance system,” said Dr. Ndenzako. He further acknowledged the continued collaboration and support from ECHO and the United States Agency for International Development (USAID) towards building a robust national disease surveillance system.

South Sudan still suffers from regular outbreaks of infectious diseases like measles, water-borne diseases such as diarrhea and Hepatitis E virus, and vector-borne diseases like malaria and yellow fever and is currently responding to the current COVID-19 pandemic. The IDSR strategy currently provides the framework for detecting, investigating, and responding to all these public health security threats using the IDSR resources available at the community, health facility, county, state, and national level.

In 2021, the Ministry of Health with support from the WHO rolled out the third edition IDSR guidelines countrywide. It also trained health workers including clinical, laboratory, data officers, and surveillance officers and continues to distribute technical guidelines to improve surveillance and response capacities.

Since its rollout, the IDSR has improved disease surveillance and reporting by over 80 percent in South Sudan.

Technical contact:
Dr Joseph Wamala, Email: wamalaj [at] who.int (wamalaj[at]who[dot]int)