Submission ID 131786
| Issue/Objective | Pandemics of Mpox, COVID-19, H1N1, SARS exposed gaps in global health security and highlighted the needs of robust surveillance system. Joint-External-Evaluation process identified <20% countries had demonstrable capacity to mitigate public health emergencies or pandemics. Integrated-Disease-Surveillance-and-Response (IDSR) is established in all provinces of Pakistan including Province-Sindh. No evaluation was done in past. This study aims to identify the critical gaps in IDSR, assess pandemic preparedness and provide recommendations. |
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| Methodology/Approach | Using a mixed-methods approach, a cross-sectional study was conducted in Province-Sindh from March-June 2025. A total of 134 key stakeholders participated including provincial and district health officials, surveillance-officers, medical officers' representatives from National-institute-of-Health and international partners. Face-to-face interviews were conducted to explore the gaps using semi-structured questionnaire. Descriptive statistics were used to summarize the stakeholder's responses. Chi-square tests and logistic-regression were applied. Thematic analysis was done for qualitative data. Epi-info version 7.2.5 and NVivo software were used for quantitative and qualitative analysis respectively |
| Results | Significant gaps were identified in the IDSR system. Eighty-percent district level stakeholders reported inadequate financial and human resources for outbreak-response and laboratory serveries (p=0.01). Sixty-five-percent (n=87) reported insufficient training on case definition, data analysis, outbreak management (p=0.02). Limited coordination among one health stakeholder was reported by all respondents (p=0.03). Capacity building (OR=2.3, 95%CI: 1.4-3.8) and coordination (OR=5.7, 95%CI: 2.5-9.8) were significantly associated with pandemic-preparedness. Qualitative data analysis identified four key gaps: limited financial and human resources for disease surveillance and outbreak response, inadequate capacity building of staff working at district level, poor coordination between one health stakeholders and limited involvement of private sectors. Participants emphasized the need for sustainable financing, digital (paperless) surveillance systems, and strengthened district laboratory capacity. |
| Discussion/Conclusion | Significant gaps in disease surveillance and response systems were identified, aggravated by limitation of resources, poor coordination and insufficient capacity building of HCW of districts. There is an urgent need for health policy reforms, including establishment of a provincial task force for coordination and formulation of provincial action plans in line with global health security. Allocation of sustainable resources with capacity building of health worker and strengthening the infrastructure will improve the province's ability to mitigate future pandemic threats |
| Presenters and Affiliations | Muhammad Asif Syed Department of Health Muhammad Asif Syed Department of Health Naveeta Pardeep Bai Department of Health Muhammad Ali Abro Department of Health |
