Positive Affect as a Transdiagnostic Target for Reducing Adolescent Depression & Suicide Risk: Do Mindfulness, Savoring, & Gratitude Help?

Malaria control and elimination heavily rely on the vigilance of health systems’ human resources to adequately and ardently perform routine surveillance activities, both passive and active []. In sub-Saharan Africa, routine surveillance of all reported diseases has adopted a de facto management structure, hinged around district-level headship, through which the mainstay reporting system, introduced around 2010, derives the name District Health Management Information Software—Version 2 (DHIS2) [–]. As such, duty performance of health management information systems (HMIS) surveillance activities by district or city health management officials (DHM), is critical. In high endemicity settings, malaria surveillance activities at the district involve the collation of data from district-supervised health facilities, monitoring quality of these data, and submitting the abstracted data to the national central authorities—mainly National Malaria control divisions/Programs (NMCP) under the leadership of national ministries of health. The Ugandan health system is comprised of a top-down hierarchy of health facilities including national referral, regional referral, and general hospitals; health centres IV, III, and II; and village health teams. It follows a hierarchy in routine reporting too, using a standard report form, HMIS 105, predominantly submitted in physical form from lower-level facilities to the respective health sub-district or district health office each month. Timely submission of a monthly report is achieved if it’s received by DHM no later than the seventh day of the next month []. Higher level hospitals have largely had direct access to the DHIS2 reporting system, thereby submitting reports online. As one goes up the reporting levels, data is submitted in aggregate format, but it remains identifiable by its source facility, sub-county, and district. Among a plethora of standard tools is Annex 8G for DHM tracking of receipt, validity, and completeness of reports per facility []. At DHM, monthly reports should be validated on a quarterly basis and evidence of action taken on findings kept []. When analysed, outputs from HMIS are expected to be discussed during quarterly performance review meetings, among others. However, the level of adherence to these standards in practice remains unclear. Enormous investments have been made to strengthen HMIS, through the development of increasingly complex data collection tools and derivative indicators and the establishment of electronic reporting systems, for example [, ]. Despite recent improvements, some inconsistencies still exist in reporting, as well as data errors and timeliness challenges, among others [, ]. Notably however, perspectives and practices of frontline HMIS data handlers in district-level health offices, who play a data gatekeeper role between health facilities and national health authorities, have hardly been assessed. Improved understanding of these aspects at this management level may foster adapted surveillance support systems and highlight key target points in the pathway to surveillance transformation into a distinct intervention. This study therefore, aimed to assess the attitude and practices of frontline officials in HMIS data recording, reporting, analysis and use, and associated support supervision, at district level.