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A review of 2013 tuberculosis (TB) surveillance data for Shamva District showed shortcomings. An average of 10 health facilities out 15 were reporting TB data on time. There was incomplete and incorrect filling of TB surveillance tools. A mixed methods (quantitative and qualitative) study was conducted between January and June 2014 and the study participants were healthcare workers. Data was collected using questionnaires and interview guide for key informants. Quantitative data was analysed using Epi-Info 7. Forty one (41) health care workers were interviewed. Females constituted (70.3%) and males 29.3%. Median age in years was 39 (IQR: 33-45) and median length of service in years was 6 (IQR: 4-9). The majority of the healthcare workers were Primary Care Nurses (43.9%). Only 22% of health care workers were trained in TB disease surveillance. Knowledge on TB symptoms and signs was above 90% but between 60%-90% on the objectives of the surveillance system. Lack of transport; lack of stationery; delay in compilation; negative attitude and motivation were mentioned as reasons for delays in reporting. Thirty three (80.5%) mentioned that the TB data collected is used in any way at their health facility. Only 19.5% had access to TB screening flow chart. 85% of the healthcare workers were willing to complete TB notification forms. Majority of health facilities did not have computers, internet access, faxes and landlines. Shortage of various TB surveillance tools was reported. We therefore concluded that knowledge levels were poor on the objectives of the surveillance system. The TB surveillance system was not simple, stable and timely but was useful, flexible, and acceptable. Mentoring, training and capacity building of healthcare workers in TB surveillance and provision of surveillance tools will improve the system performance.

Evaluation of the Tuberculosis Surveillance System in Shamva District, Zimbabwe, 2014