Evaluation of the implantation of the Notifiable Diseases Information System in Pernambuco state, Brazil, 2014

Maia, Daniely Aleixo Barbosa; Frias, Paulo Germano de; Assunção, Romildo Siqueira; Vidal, Suely Arruda; Vanderlei, Lygia Carmen de Moraes

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Brasil

Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 28 (1) • 2019 • https://doi.org/10.5123/S1679-49742019000100002 copy

Evaluation of the implantation of the Notifiable Diseases Information System in Pernambuco state, Brazil, 2014^* * Article derived from the Master’s Degree dissertation entitled ‘Evaluation of the implantation of the Notifiable Diseases Information System in Pernambuco’, submitted by Daniely Aleixo Barbosa Maia to the Professional Master’s Degree Course, Health Evaluation Postgraduate Programme, Prof. Fernando Figueira Institute of Integral Medicine, on December 23rd 2015.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to evaluate the implantation of the Notifiable Diseases Information System (SINAN) in Pernambuco, Brasil, 2014.

Methods:

This was an evaluation study based on primary data (interviews) and secondary data (SINAN documents/data) provided by the State Health Department and its Regional Divisions in order to estimate the degree of SINAN implantation, comparing structure and process indicators with results achieved.

Results:

SINAN was found to be partially implemented at central level (77.2%); and at regional level (61.2%), ranging from 54.7 to 71.6%; the following components had been implemented: reporting/investigation (90.0%) and processing (84.1%); analysis/divulgation had been partially implemented (61.6%); while monitoring (53.4%) and management (56.8%) were incipient; there was a lack of planning and published information bulletins; 46.9% of municipalities closed compulsory reporting on time; 68.7% sent batches regularly, 3.0% of tuberculosis cases were duplicated.

Conclusion:

SINAN was found to be partially implemented in Pernambuco due to shortcomings in monitoring and management, with negative influences on system results; its strengths related to reporting, investigation and data processing.

Keywords:
Health Evaluation; Information Systems; Disease Notification; Epidemiological Monitoring

Component	Health regions and degree of implantation												Regional Level	Central Level	State
Component	I	II	III	IV	V	VI	VII	VIII	IX	X	XI	XII	Regional Level	Central Level	State
Management	46.0	48.0	40.0	48.0	54.0	46.0	58.0	54.0	50.0	48.0	58.0	46.0	49.7	64.0	56.8
Structure	63.6	50.0	72.7	68.2	72.7	72.7	77.3	63.3	50.0	45.5	54.5	63.6	62.9	68.2	65.5
Process	32.1	46.4	14.3	32.1	39.3	25.0	42.9	46.4	50.0	50.0	60.7	32.1	39.3	60.7	50.0
Notification and investigation	70.0	70.0	100.0	100.0	85.0	70.0	70.0	70.0	85.0	70.0	100.0	70.0	80.0	100.0	90.0
Structure	33.3	33.3	100.0	100.0	66.7	66.7	33.3	33.3	100.0	33.3	100.0	33.3	61.1	100.0	80.6
Process	100.0	100.0	100.0	100.0	100.0	72.7	100.0	100.0	72.7	100.0	100.0	100.0	95.5	100.0	97.7
Monitoring	33.8	57.5	32.5	38.8	47.5	38.8	70.0	30.0	55.0	26.3	55.0	47.5	44.4	62.5	53.4
Structure	75.0	75.0	50.0	100.0	75.0	75.0	75.0	50.0	75.0	50.0	100.0	50.0	70.8	75.0	72.9
Process	23.4	53.1	28.1	23.4	40.6	29.7	68.8	25.0	50.0	20.3	43.8	46.9	37.8	59.4	48.6
Data processing	85.0	75.0	72.5	85.0	85.0	85.0	85.0	70.0	85.0	70.0	85.0	85.0	80.6	87.5	84.1
Structure	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Process	78.6	64.3	60.7	78.6	78.6	78.6	57.1	78.6	57.1	78.6	78.6	78.6	72.3	82.1	77.2
Information analysis and publicizing	48.0	40.0	44.0	48.0	48.0	40.0	70.0	44.0	84.0	44.0	60.0	44.0	51.2	72.0	61.6
Structure	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Process	13.0	-	6.7	13.3	13.3	-	50.0	6.7	73.3	6.7	33.3	6.7	18.6	53.3	36.0
SINAN	56.6	58.1	57.8	64.0	63.9	56.0	67.6	56.6	68.8	54.7	71.6	58.5	61.2	77.2	69.2

Component/Indicator	Health Regions												Regional Level	Central Level	State
Component/Indicator	I	II	III	IV	V	VI	VII	VIII	IX	X	XI	XII	Regional Level	Central Level	State
Management
No. of SINAN plannings undertaken annually	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
Notification and investigation
Individual notification with duplicated number	3.9	4.4	0.1	0.1	0.1	0.1	0.1	0.2	0.3	0.7	0.1	0.1	0.8	2.6	1.7
Ratio of expected and notified CND a cases	1.1	1.3	0.5	1.8	0.3	0.0	0.0	0.0	2.0	-	-	1.3	0.7	1.1	0.9
Regional consistency of notification volume	36.9	24.1	24.2	30.5	25.0	24.2	32.1	33.2	28.3	29.4	31.5	24.7	28.7	28.7	28.7
Monitoring
Municipalities with irregular input to SINAN	-	-	4.5	-	-	-	-	-	-	-	-	-	0.4	0.5	0.5
Timely closure of CND a investigations	77.6	72.5	72.3	73.5	77.8	78.9	92.9	94.5	85.3	75.0	80.0	69.9	79.2	77.0	78.1
Municipalities with timely closure of ≥80% CND a cases	50.0	55.0	40.9	34.4	47.6	46.2	42.9	71.4	36.4	50.0	50.0	50.0	47.9	45.9	46.9
Timely notification of ICND b cases	12.4	24.4	15.9	30.7	8.3	24.2	16.7	26.5	43.8	21.4	37.5	15.2	23.1	13.6	18.3
Timely input of ICND b cases	20.7	48.8	31.7	50.0	50.0	39.4	54.2	18.4	43.8	64.3	37.5	38.0	41.4	23.6	32.5
Data processing
Regular sending of EW c in transfer batches /year	88.5	86.5	88.5	98.1	90.4	92.3	88.5	94.2	92.3	88.5	98.1	80.8	90.5	82.7	86.6
Municipalities with ≥80% regular batch sending	50.0	75.0	63.6	71.9	61.9	76.9	-	100.0	36.4	100.0	90.0	100.0	68.8	68.6	68.7
Information analysis and publicizing
Completeness of tuberculosis notification forms	12.4	11.0	10.3	10.0	10.0	10.7	10.8	9.8	10.2	10.6	9.1	10.9	10.5	9.7	10.1
Completeness of leptospirosis notification forms	7.5	9.7	9.4	6.7	5.2	13.1	13.1	13.1	10.6	13.1	13.1	9.5	10.3	7.3	8.8
% of leptospirosis cases duplicated on SINAN	0.6	-	-	-	-	-	-	-	-	-	-	-	0.1	0.5	0.3
% of tuberculosis cases duplicated on SINAN	3.0	2.2	3.2	2.7	5.4	3.4	2.6	0.0	6.9	6.3	-	-	3.0	2.9	3.0
Inconsistent recording of leptospirosis ‘final classification’ and ‘criterion’	1.1	-	-	-	-	-	-	-	-	-	-	-	0.8	1.3	1.0
Inconsistent recording of leptospirosis ‘evolution’ and ‘date of death’	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
Inconsistent recording of tuberculosis ‘clinical form’ and ‘spuum smear microscopy’	0.5	-	0.4	-	-	-	-	1.3	-	-	-	-	0.2	0.4	0.3
Inconsistent recording of tuberculosis ‘clinical form’ and ‘whether extrapulmonary’	-	-	-	-	-	-	-	0.7	-	-	-	-	0.1	-	-
% epidemiological bulletins and profiles prepared and publicized	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-

Component	Degree of implantation (%)	Indicadores	Metas	Resultado
Management	56.8 (incipient)	No of SINAN plannings undertaken annually	1	-
Notification and investigation	90.0 (implemented)	Individual notification with duplicated number	<5%	1.7
		Ratio of expected and notified CND a cases	1	0.9
		Regional consistency of notification volume	>80%	28.7
Monitoring	53.4 (incipient)	Municipalities with irregular input to SINAN	zero	0.5
		Timely closure of CND a investigations	≥80%	78.1
		Municipalities with timely closure of ≥80% CND a cases	≥50%	46.9
		Timely notification of ICND b cases	100%	18.3
		Timely input of ICND b cases	100%	32.5
Data processing	84.1 (implemented)	Regular sending of EW c in transfer batches /year	≥80%	86.6
Data processing	84.1 (implemented)	Municipalities with ≥80% regular batch sending	≥50%	68.7
Information analysis and publicizing	61.6 (partially implemented)	Completeness of tuberculosis notification forms	>8.9	10.1
		Completeness of leptospirosis notification forms	>8.9	8.8
		% of leptospirosis cases duplicated on SINAN	≤5%	0.3
		% of tuberculosis cases duplicated o SINAN	≤5%	3.0
		Inconsistent recording of leptospirosis ‘final classification’ and ‘criterion’	≤5%	1.0
		Inconsistent recording of leptospirosis ‘evolution’ and ‘date of death’	≤5%	-
		Inconsistent recording of tuberculosis ‘clinical form’ and ‘sputum smear microscopy	≤5%	0.3
		Inconsistent recording of tuberculosis ‘clinical forma’ and ‘whether extrapulmonary’	≤5%	-
		% of epidemiological bulletins and profiles prepared and publicized	≥50%	-

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[1] Correspondence: Lygia Carmen de Moraes Vanderlei - Av. Parnamirim, No. 98/401, Parnamirim, Recife, PE, Brazil. Postcode: 52060-000 E-mail: lygiacarmen@yahoo.com.br