Feasibility of implementing recommendations to improve communicable diseases surveillance--a modified Delphi study.

BACKGROUND Effective control of communicable diseases requires an effective disease surveillance system (CDSS) which provides information for action on priority communicable diseases. It is the basis for public health decision-making worldwide. Implementation of any public health recommendations for improving a disease surveillance system depends on the acceptability of such recommendations by the relevant stakeholders and the feasibility of implementing the recommendations in practice. OBJECTIVES The aim of this study was to assess the acceptability and the feasibility of recommended improvements in CDSS among relevant stakeholders in Khartoum state. METHODS A Delphi consensus process was used in the form of three analytical written rounds and individual face-to-face discussions among relevant stakeholders in Khartoum state to study the feasibility of the recommended improvements in CDSS in Khartoum state. RESULTS The stakeholders in Khartoum state agreed with most of our statements to improve the CDSS core activities, supportive functions and quality in Khartoum State, and that the existing CDSS in Khartoum state needs to be strengthened with more effective coordination at different levels. Regarding the feasibility of implementing our recommendations, the results of our Delphi survey suggest neither expanding CDSS system, nor including vertical programmes; formulation of updated objectives; improving data management and feedback; strengthening epidemic management, as well as the quality of the system in terms of timeliness, completeness and acceptability. CONCLUSION This study added strength to our recommendations, based on two previous studies assessing the CDSS in Khartoum state. The Ministry of Health in Khartoum state can implement our consensus recommendations to improve the CDSS system in the future in order to achieve its targeted goals.