Freetown ‒ Between 2014 and 2016, the highly infectious Ebola Virus Disease (EVD) outbreak in Sierra Leone and neighboring countries claimed the lives of over 4000 men, women and children in the country. At the time, the surveillance system, which was partially rolled out in 2003 by the Ministry of Health and Sanitation (MoHS), was weak and rudimentary. The need to strengthen IDSR to ensure prompt detection and response to epidemic-prone diseases was urgent.
Revitalization and transformation efforts by the MoHS commenced with adaptation of updated Integrated Disease Surveillance and Response (IDSR) guidelines and the creation of tailored national guidelines to align with regional and global frameworks. To ensure effective data management, public health experts carefully defined the flow of information, system operations, case definitions, reporting frequency, and channels of information dissemination.
In close cooperation with other partners, like African Field Epidemiology Network (AFENET), eHealth Africa, and the US Centers for Disease Control, and with funding from donors, World Health Organization (WHO) provided technical and financial support for the adaption of IDSR technical guidelines. The WHO-led training and supportive supervision, and provision of IDSR tools for case reporting and investigation, were instrumental in rolling out the IDSR strategy to all health facilities. IDSR focal points from health facilities and District Health Management Teams (DHMTs) were trained on all priority diseases.
WHO also supported the development and operationalization of an electronic IDSR reporting platform (eIDSR), which enabled the Ministry of Health and Sanitation to establish a functional public health surveillance system in Sierra Leone. That enhanced the national capacity to effectively prevent, detect and respond to public health events and emergencies.
Rapid Response Teams were also formed and trained to investigate and respond to disease outbreak alerts in all districts. Together with the Health Ministry, WHO conducts monitoring activities, including periodic supportive supervision and data quality assessments.
Currently, the epidemic intelligence system in Sierra Leone has evolved from its pre-EVD paper-based approach to the current modern electronic integrated disease surveillance and response system that can efficiently detect and trigger the response to a disease outbreak or event.
The rate of reporting has shown a significant improvement, starting from about 60% in 2015, rising to an average of 98% for both completeness and timeliness in 2023. Additionally, successful cross-border collaboration and coordination have been established with neighbouring Liberia and Guinea. This has significantly improved sharing of information and experiences.