JMIR Publications

ABSTRACT

Background:

The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated.

Objective:

This study aimed to assess the performance of NTSS and determine its strength and weaknesses to recommend improvements.

Methods:

The Centers for Disease Control and Prevention (CDC) guidelines were used for evaluating the NTSS. The centrals' stakeholders, districts' surveillance coordinators, and facilities' focal points were interviewed to rate the attributes of the NTSS. The percent scores for attributes were ranked as poor (<60%), average (≥ 60- <80%) and good (≥ 80%.

Results:

The overall usefulness score percent was 38%, which indicates a poor performance. The performance of the NTSS was rated as an average on the flexibility (Score percent: 68%) and acceptability (Score percent: 64%) attributes and was rated as poor on stability (Score percent: 33%), simplicity (Score percent: 57%), and representativeness (Score percent: 39%) attributes. About 65% of investigation forms were filled within 48 hours of notification date. The data quality was poor as 41% of the core variables were missing.

Conclusions:

The overall performance of the NTSS was poor. Most of the system attributes require improvement such as stability, simplicity, quality of data and completeness of investigation. To improve the performance of NTSS, the followings are recommended: Capacity building of staff (focal points), strengthening NTSS through technical support and government funding to ensure its sustainability, establishing an electronic investigation forms for improving the system data quality, and expansion of the NTSS coverage to include all private healthcare facilities.