Unit 9: Evaluating a Public
Health Surveillance System
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Warm Up Questions: Instructions

Take five minutes now to try the Unit 9 warm
up questions in your manual.

Please do not compare answers with other
participants.

Your answers will not be collected or graded.

We will review your answers at the end of the
unit.
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What You Will Learn

By the end of this unit you should be able to:

list tasks for evaluating a surveillance
system

develop a plan for evaluating your own
country’s surveillance system
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Why Evaluate?

Evaluation ensures that your HIV/AIDS
surveillance system remains effective as the
epidemic shifts over time.

If your system is no longer effective, you will
not have the right information to control
HIV/AIDS.
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Purpose of Evaluation

Appraise and prioritise the disease events to
be kept under surveillance

Assess how the system can detect and report
these diseases

Assess the quality of the epidemiologic
information produced
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Purpose of Evaluation, Cont.

Assess how the system can respond to these
diseases

Assess how surveillance results affect
disease control and policy

Identify which elements of the system can be
enhanced in order to improve the quality of
information
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Figure 9.1. Elements of an
Evaluation
Evaluation
 Document
current state of the
surveillance system
 Identify
strengths and weak
points
 Recommend
 Define
improvements
training requirements or
gaps
 Justify
 Additional
funding
 More
possible
outcomes
and better
training
 Improved
surveillance for
better disease
control
resources
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Six Evaluation Tasks
1. Engage the stakeholders in the evaluation.
2. Describe the surveillance system to be
evaluated.
3. Focus the evaluation design.
4. Gather credible evidence regarding the
performance of the surveillance system.
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Six Evaluation Tasks, Cont.
5. Justify and state conclusions and make
recommendations.
6. Ensure use of evaluation findings and share
lessons learned.
For more detail, refer to the Updated Guidelines for Evaluating Public
Health Surveillance Systems (Centers for Disease Control and
Prevention, 2001), available at
www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm
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Task 1: Engaging Stakeholders
in the Evaluation

Stakeholders include:
 Public health practitioners
 Healthcare providers
 Data providers and users
 Community representatives
 Governments at the district, provincial and
national levels
 Governmental, non-governmental,
professional and private non-profit
organisations
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Task 1: Engaging Stakeholders
in the Evaluation, Cont.

Examples of ways to engage stakeholders
include:
 Hold a community meeting to discuss
plans for the evaluation.
 Hold one-on-one meetings with the key
people listed above.
 Invite participants to join the evaluation
team.
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Class Discussion: Task 1

Task 1 is to ‘engage stakeholders.’
Who would this be, in your case?
 Why is this task important?

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Task 2: Describe the Surveillance
System to be Evaluated

The evaluation should describe:

The public health importance of the healthrelated event under surveillance

The purpose and operation of the system

The resources used to operate the system
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Class Discussion: Task 2

Task 2 is to ‘describe the surveillance
system.’

In your case, where would you find the
type of information listed in the task?
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Task 3: Focus the Evaluation
Design

Determine the specific purpose of the evaluation.

Identify stakeholders who will receive findings.

Consider what to do with the information
generated from the evaluation.

Specify the questions that will be answered.

Determine the standards for assessing the
performance of the system.
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Class Discussion: Task 3

For task 3:
What are some ways you can think of to
design an evaluation?
 How would you know what to evaluate?

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Task 4: Gather Credible Evidence
Regarding the Performance of the
Surveillance System
Describe the surveillance system in terms of its:





Simplicity
Flexibility
Data quality
Acceptability
Positive predictive
value




Representativeness
Timeliness
Stability
Data use/
dissemination
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Class Discussion: Task 4

Task 4 concerns gathering data.
Should there be a time limit on gathering
data?
 What would you do if you found that some
clinics didn’t have data or had incomplete
data?

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Task 5: State Conclusions and
Make Recommendations

Conclusions can be justified through
appropriate analysis, synthesis, interpretation
and judgment of the gathered evidence.

Recommendations should address
modifications and continuations of the public
health surveillance system.
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Class Discussion: Task 5

In task 5, you are asked to make
recommendations.

How is this typically done in your district or
region?
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Task 6: Ensure Use of Findings
and Share Lessons Learned

Develop strategies for communicating the
findings from the evaluation.

Tailor recommendations to relevant
audiences.

Recommendations for improvements should
be distributed to all partners and sites
involved in sentinel surveillance.
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Class Discussion: Task 6

Task 6 concerns communications.
How would you decide whom to send your
final report to?
 In your case, would the report go to subject
matter experts, perhaps Ministry of Health
HIV/AIDS experts?
 If not, how could you make sure that the
people reading the report would
understand what you were saying?

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In Summary

Evaluating your HIV/AIDS surveillance system is
important, to ensure that remains effective as the
epidemic changes over time.

The tasks that you should implement during this
evaluation include:
 engaging stakeholders
 describing the surveillance system
 focusing the evaluation design
 gathering evidence on the system’s performance
 stating conclusions and recommendations
 sharing the lessons learned
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Warm Up Review

Take a few minutes now to look back at your
answers to the warm up questions at the
beginning of the unit.

Make any changes you want to.

We will discuss the questions and answers in
a few minutes.
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Answers to Warm Up Questions
1. List three stakeholder groups that should be
engaged during the evaluation of the
surveillance system.
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Answers to Warm Up Questions
1. List three stakeholder groups that should be
engaged during the evaluation of the
surveillance system.






public health practitioners
healthcare providers
government officials
representatives of affected communities
non-profit and donor organizations
etc.
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Answers to Warm Up Questions,
Cont.
2. If there is a high probability that cases
identified by the surveillance system are
actually cases of HIV infection, the system is
said to have high:
a. sensitivity
b. representativeness
c. acceptability
d. positive predictive value
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Answers to Warm Up Questions,
Cont.
2. If there is a high probability that cases
identified by the surveillance system are
actually cases of HIV infection, the system is
said to have high:
a. sensitivity
b. representativeness
c. acceptability
d. positive predictive value
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Small Group Discussion:
Instructions

Get into small groups to discuss these
questions.

Choose a speaker for your group who will
report back to the class.
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Small Group Reports

Select one member from your group to
present your answers.

Discuss with the rest of the class.
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Case Study: Instructions

Try this case study individually.

We’ll discuss the answers in class.
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Case Study Review

Follow along as we go over the case study in
class.

Discuss your answers with the rest of the
class.
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Questions, Process Check

Do you have any questions on the information
we just covered?

Are you happy with how we worked on Unit 9?

Do you want to try something different that will
help the group?
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