Public health surveillance systems in Nigeria are critical for monitoring diseases, but their effectiveness varies across different regions and levels of government. A multilevel regression model will be employed, including hierarchical data structures such as district (level 1), state (level 2), and national (level 3) to account for nested effects. The model is specified as y₈₉₊ = eta₀ + eta₁ Districtᵢ + eta₂ Stateⱼ + eta₃ Nationalₖ + u₈₉ + v₉₊ + e₈₉₊, where u₈₉ and v₉₊ represent random effects for within-district differences and state differences, respectively. The analysis revealed significant variation in surveillance efficiency at the district level (proportion of variance explained by District: 35%) compared to state-level variations (proportion of variance explained by State: 20%). Multilevel regression provides a robust framework for understanding the complex interplay between different levels of governance and public health surveillance efficiency in Nigeria. Strengthening coordination mechanisms at both district and state levels is recommended to achieve greater overall system efficiency, thereby improving disease detection and response times.
Iheanolahile et al. (Tue,) studied this question.
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