Problem analysis on the lack of surveillance reporting tools in the Bongo District, Upper East Region, Ghana, 2025

Abstract

Introduction: Effective disease surveillance relies on timely and accurate reporting; however, health facilities in the Bongo District face recurrent shortages of standardized reporting tools, such as registers and Integrated Disease Surveillance and Response (IDSR) forms. This analysis investigated the root and critical causes of the unavailability of surveillance reporting tools in selected health facilities in the Bongo District and determined the extent of control facilities over the root causes. Methods: A problem analysis was conducted in three health facilities in the Bongo District using focus group discussions with 24 stakeholders across seven professional cadres. Data were analyzed using a fishbone framework to classify contributory factors into total, partial, and no control. Results: Nineteen root causes were identified in this study. Approximately 26.3% (5/19) were totally controllable at the facility level, 63.2% (12/19) were partially controllable through collaboration with higher levels, and 10.5% (2/19) were external. Weak forecasting and inadequate re-ordering practices were the most critical factors contributing to shortages. Conclusion: Nineteen root causes of tool shortages were identified, with inadequate reordering practices being the most critical cause. Nearly 80% of these causes were within the health system’s control, indicating a significant potential for improvement. Strengthening quantification practices, building staff capacity in forecasting, and institutionalizing regular supervision are essential to ensure consistent availability of surveillance tools and enhance public health responsiveness.