Assessment of the Practice of Disease Surveillance and Notification in Ebonyi State, Nigeria

Background: Disease surveillance and notification (DSN) is a core component of the Health Management Information System and is critical for early detection and control of epidemic-prone diseases. The effectiveness of DSN depends largely on the awareness, knowledge, and practices of frontline health workers at community and facility levels. Objective: This study aimed to assess awareness, knowledge, and practices related to DSN among village health workers (VHWs) and facility-based health workers in Ebonyi State, Nigeria, and to identify factors contributing to incomplete and delayed reporting. Materials and Methods: A mixed-methods descriptive cross-sectional study was conducted across all 13 Local Government Areas of Ebonyi State. Quantitative data were collected using pretested questionnaires administered to 385 VHWs and 323 facility-based health workers selected through random sampling. Qualitative data were obtained through a focus group discussion involving all 13 Disease Surveillance and Notification Officers. Data were analyzed using descriptive statistics and chi-square tests. Results: Among VHWs, 68% were aware that diseases should be reported, but 57% could correctly state the purpose of reporting. Lower educational attainment was significantly associated with difficulty completing DSN reporting forms (odds ratio = 3.85; 95% confidence interval: 2.40–6.20; P <0.001). Among facility-based workers, 90% demonstrated awareness of DSN, but 51% correctly identified diseases on the routine notification list, and 47% were unfamiliar with standard case definitions. Qualitative findings highlighted inadequate financial incentives, irregular supply of DSN forms, and lack of feedback as major barriers to timely reporting. Conclusion: Despite high awareness, deficiencies in practical knowledge, logistics, and motivation limit optimal DSN performance. Strengthened training, reliable reporting tools, feedback mechanisms, and improved incentives may enhance surveillance effectiveness.