JMIR Publications

ABSTRACT

Background:

Malnutrition remains one of the most common causes of morbidity and mortality among children in low and middle‐income countries. It is one of the important problems that showed an increasing incidence in Yemen. The Nutrition Surveillance System (NSS) started in 2018 as a pilot in five governorates to ensure that difficulties of public health importance are monitored efficiently.

Objective:

To assess its usefulness, and performance of the system attributes, and identify strengths and weaknesses to make recommendations for improvement.

Methods:

CDC updated guidelines of the evaluation of public health surveillance were used to evaluate the NSS in Sana’a city. Qualitative and quantitative attributes were measured through desk review and in-depth interviews with stakeholders from different levels by used semi-structured questionnaire for collected data. The percent mean of total scores was used for the final rank of the performance as: very poor (<40%), poor (40%<60%), average (60%<80%), good (80%<90%) and excellent (≥90%). The Epi info version 7.2 was used for data entry and analysis.

Results:

The NSS was found to be useful and flexible with overall score 100% and 80%, respectively, and overall system performance was average 76%. The highest attribute score was 83% for simplicity and the lowest score was 67% for stability. Although simplicity and acceptability in the governorate and district levels were good but in health facilities level were average. Timeliness of report, completeness of forms and data were 100%, 95% respectively. The main NSS strength was continuous expansion in opening new health facilities and quality of data was strong with updated databases.

Conclusions:

NSS in Sana’a city was found to be useful and met its main objective. Overall levels of system performance were average. Regular training for health staff at the health facilities and gradual replacement of donor’s with government's funds are recommended.