Comprehensive Vaccine-Preventable Disease Surveillance in the Western Pacific Region: A Literature Review on Integration of Surveillance Functions, 2000–2021

Morgane Donadel; Heather M. Scobie; Roberta Pastore; Varja Grabovac; Nyambat Batmunkh; Stephanie O’Connor; Benjamin A. Dahl; Christopher S. Murrill

doi:10.9745/GHSP-D-22-00017

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FIGURE.
Flow Chart of Literature Review on Comprehensive Vaccine-Preventable Disease Surveillance in the WHO Western Pacific Region, 2000–2021
Abbreviation: WHO, World Health Organization.

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TABLE 1.

Potential Areas of Integration Among Vaccine-Preventable Disease Surveillance Support Functions^a

Surveillance Support Functions	Potential Areas for Integration
Governance	Standards and guidelines development, policy, laws/mandates, roles and responsibilities (including for private sector), and funding
Program management	Budget creation, resource mobilization, financial management, sustainability, infrastructure/equipment management, human resources, and external surveillance assessments and reviews
Workforce capacity	Training/capacity building at all levels; staff for core functions including case detection, notification, investigation, reporting, and response; and epidemic preparedness
Laboratory	Specimen collection kits, reagents, and supplies; equipment; physical space; training; personnel; expansion and diversification of regional and global networks; shared procurement processes; and quality management systems
Field logistics and communication	Airtime and Internet for notification and reporting, specimen collection, and transport; and feedback of results
Supervision	Supportive supervisory visits, workplans, and checklists
Data management and use	Information system development; and data harmonization, implementation, and use for performance improvement
Coordination	Linking surveillance program to relevant stakeholders (e.g., EPI) for data review, dissemination, and use; improvement planning; surveillance strengthening as core function of International Health Regulations implementation framework, including rapid response teams and emergency operations centers

Abbreviation: EPI, Expanded Program on Immunization.
↵a From the World Health Organization Global Strategy on Comprehensive Vaccine-Preventable Disease Surveillance.²

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TABLE 2.

References Reporting Integration by WHO Surveillance Support Function

Surveillance Support Functions	Published References, No. (%) (n=45)	Gray Literature References, No. (%) (n=42)	Total References, No. (%) (n=87)
Laboratory	26 (58)	23 (55)	49 (56)
Workforce capacity	29 (64)	18 (43)	47 (54)
Governance	26 (58)	18 (43)	44 (51)
Data management and use	24 (53)	17 (40)	41 (47)
Field logistics and communication	20 (44)	21 (50)	41 (47)
Coordination	8 (18)	5 (12)	13 (15)
Program management	4 (9)	7 (17)	11 (13)
Supervision	2 (4)	6 (14)	8 (9)

Abbreviation: WHO, World Health Organization.

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TABLE 3.

Best Practices and Innovations in Comprehensive Vaccine-Preventable Disease Surveillance Implementation in the WHO Western Pacific Region, by WHO Surveillance Function

Surveillance Support Functions	Best Practices and Innovations
Laboratory	Using the same equipment, reagents, and supplies for testing multiple VPDs Integrating trainings on laboratory techniques applicable to multiple VPDs (e.g., bacterial VPD confirmation) Using multiplex tests or multiple tests of the same syndromic sample
Workforce capacity	Preservice and on-the-job competency-based training programs to strengthen surveillance data capacity at all levels of the surveillance workforce Adequate number of trained and experienced staff to conduct case detection, notification, investigation, reporting, and response
Governance	Engagement of national EPI in the process of development and implementation of integrated surveillance Government leadership in fostering collaborative partnerships between the public and private sectors National funding for integrated surveillance operations Quality operational guidelines for surveillance of multiple VPDs
Data management and use	Integrated/interoperable information systems, including different VPDs based on EPI user requirements and local context Linkage between epidemiological and laboratory surveillance data for individual cases Joint epidemiological and laboratory surveillance data review meetings Triangulation of coverage and VPD surveillance data to better identify immunity gaps in the population Surveillance data use for EPI planning Integrated VPD serosurveys and data use for EPI planning
Field logistics and communication	Using the same shipment mechanisms for specimen transport for multiple VPDs Using information and communication technology tools for clinician sensitization and notification of suspect cases to strengthen the representativeness and timeliness of reporting
Coordination	Linking surveillance to EPI program units for data review, dissemination, and use Emergency Operations Center’s coordination of surveillance, outbreak investigation, and response
Program management	VPD surveillance reviews, including multiple VPDs VPD surveillance workforce needs are addressed at all levels as part of the national human resource planning
Supervision	Regular supportive supervisory visits provided to surveillance staff of all administrative levels