Dirty data: disease surveillance in Arua District, Uganda

Integrated Disease Surveillance is the current modus operandi for emergency and disaster preparedness and Response in Uganda. In this article, the author presents a detailed analysis of one component of disease surveillance - reporting, as conducted in Arua District in 2001/2002. Although time has passed and changes for the better may have taken place, the article raises a number of issues and practices common to surveillance systems in other places. These include lateness of reporting, incomplete reports and most importantly, data inaccuracy. The article highlights managerial weaknesses in the management of the district health system that greatly affect disease surveillance. Finally, even before the Ugandan Ministry of Health introduced its now (in)famous 'League Tables' the author proposes models of categorising Health Sub-Districts according to performance, effectively suggesting a precursor to the current tables.