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Impact of Kenya's Frontline Epidemiology Training Program on Outbreak Detection and Surveillance Reporting: A

Daniel Macharia¹, Yuka Jinnai¹, Mitsuaki Hirai¹

¹Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health.

Health Security

|May 10, 2021

Abstract:

Rapid detection and response to infectious disease outbreaks requires a robust surveillance system with a sufficient number of trained public health workforce personnel. The Frontline Field Epidemiology Training Program (Frontline) is a focused 3-month program targeting local ministries of health to strengthen local disease surveillance and reporting capacities. Limited literature exists on the impact of Frontline graduates on disease surveillance completeness and timeliness reporting. Using routinely collected Ministry of Health data, we mapped the distribution of graduates between 2014 and 2017 across 47 Kenyan counties. Completeness was defined as the proportion of complete reports received from health facilities in a county compared with the total number of health facilities in that county. Timeliness was defined as the proportion of health facilities submitting surveillance reports on time to the county. Using a panel analysis and controlling for county-fixed effects, we evaluated the relationship between the number of Frontline graduates and priority disease reporting of measles. We found that Frontline training was correlated with improved completeness and timeliness of weekly reporting for priority diseases. The number of Frontline graduates increased by 700%, from 57 graduates in 2014 to 456 graduates in 2017. The annual average rates of reporting completeness increased from 0.8% in 2014 to 55.1% in 2017. The annual average timeliness reporting rates increased from 0.1% in 2014 to 40.5% in 2017. These findings demonstrate how global health security implementation progress in workforce development may influence surveillance and disease reporting.

Keywords:

Field Epidemiology Training Program Field Epidemiology and Laboratory Training Program Infectious disease outbreak International Health Regulations Surveillance Workforce development

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