IMPLEMENTATION EWARS (EARLY WARNING ALERT AND RESPONSE SYSTEM) IN THE PALEMBANG HEALTH DEPARTEMENT 2013

Abstract

Background : EWARS is one of the tools in surveillance to determine early warning signal / potential outbreaks of infectious disease threats. As many as 16.897 alerts in 2011 were in 6 Provinces. In September of 2012 the Director General of the PP and PL MoH  socialized EWARS to 8 new provinces including South Sumatra. System effectively ran in the 1st week of January 2013 at the level of Palembang health departement.  Until 11^th week, from 39 health centers there were only 25 health centers that completed the weekly report. This implied that completeness weekly report at 11^th week  was 64%.  Compared to national indicators in the Ministry of Health Decree No.1479 / Menkes / SK / X / 2003, the completeness of report was  90%. Therefore this study aimed to determine the overall description of the implementation EWARS in Palembang Health departement.

Methods : A descriptive research using qualitative approach was implemented in this study based on framework for program evaluation in public health, CDC. The  informants in this study were  Chief of Surveillance Section, Head of health centers based on complete report level, surveillance officer and health center officers. The methods for obtaining information were  in-depth interview, observation and document review. Content analysis was used for analyzing the data. The results were presented in matrix and narrative forms.

Results : The description  of the resources needed was good. Reporting activities have not yet fully involved health centers. Hence,  the data that were sent to the health department were limited to the data of patients who went to the health centers. Key informants told that EWARS did not influence the  environment.  Moreover, there was lack  of  awareness of officer  in sending weekly  report on time . Until the 18^th week the  system detected  202 alerts/early warnings. The highest number of alerts was dominated by suspected measles; the number was  63 alerts. Alert proficiency level has been followed up by sending a specimen to the laboratory of South Sumatra Province. Weekly and monthly monitoring were good.

Conclusion : Lack of inputs such as human resources, funding and other equipment to be an obstacle for the implementation of this program. In addition to the implementation process needed awareness and discipline all officers in order to produce accurate data and information and also on time. Overall, the EWARS implementation in Palembang Health Department still needs improvement in terms of accuracy and completeness of the report. Health authorities need to pay attention to deficiencies contained in the input and monitor the implementation of the EWARS program  regularly and make bulletins as feedback to the health center.

Keywords : Implementation, EWARS, weekly reports