A model to target effective vaccine-preventable disease surveillance programme: Qualitative evidences from a private healthcare facility in Bhubaneswar, Odisha

A BSTRACT Introduction: Vaccine-preventable diseases (VPD) surveillance provides continuous, long-term evidence-based information that allows timely detection and response to the VPD in-addition to monitoring the existing National Immunization Programs. Objective: To explore the challenges experienced by the VPD Surveillance team of a private healthcare facility in Bhubaneswar regarding barriers to effective surveillance. Materials and Methods: Qualitative descriptive exploratory study was conducted during April-September 2024 at a private healthcare facility, Bhubaneswar. In-depth interviews using semi-structured questionnaire were conducted among team members from all tiers, involved in VPD surveillance at centre, in collaboration with WHO. At all levels of surveillance: suspected case identification, notifying sample collection team, case-investigation form filling and submission, blood/nasal discharge/stool sample collection, storage and transportation, challenges faced were explored. Results: Key themes on challenges that emerged on analysis were ill-defined surveillance framework within centre, inadequate and unorganized resources for case identification and reporting weakening infrastructure for surveillance, paper-based notification system causing misplaced CIF and/or delayed reporting, delayed/lack of lab testing capacity, mislabelling of sample and its storage and transportation under inappropriate temperature, delay in sample collection as key determinant of sample wastage, lack of testing due to the patient hesitancy to get interviewed or tested causing insufficient data collection and missed opportunities for case detection. Conclusion: Revamping strategies is needed at healthcare centre surveillance system to overcome multifaceted challenges. This can be achieved through implementation of standardized surveillance framework, enhanced training for healthcare workers, digitalization of notification system, improved laboratory infrastructure.