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Volume 16, Number 10—October 2010

Research

Mobile Phone–based Infectious Disease Surveillance System, Sri Lanka

Colin Robertson1Comments to Author , Kate Sawford1, Samson L.A. Daniel2, Trisalyn A. Nelson, and Craig Stephen
Author affiliations: Author affiliations: University of Victoria, Victoria, British Columbia, Canada (C. Robertson, T.A. Nelson); Wilfrid Laurier University, Waterloo, Ontario, Canada (C. Robertson); University of Calgary, Calgary, Alberta, Canada (K. Sawford, C. Stephen); Ministry of Livestock Development, Colombo, Sri Lanka (S.L.A. Daniel)

Main Article

Table 3

Lessons learned in planning and implementing surveillance systems, Sri Lanka, January 1–September 30, 2009*

Consideration for surveillance in lower-resource settings IDSAS experience Generalized lessons
Technical Cell phones permitted timely collection and transmission of data to the surveillance system. Touch screen interfaces were new technology for field veterinarians. Use of familiar technologies such as basic cell phones will minimize training time. Cell phones enable timely data collection and transmission.

Ongoing training was essential. A local research assistant made training more effective, in particular because field veterinarians could learn the system in their native languages.
Developing local expertise at the project outset is invaluable for ensuring sustained technical and logistical support.
Financial Hardware required for data collection was relatively inexpensive but much more expensive than hardware available in Sri Lanka. Importing cell phones for the project was challenging. Where possible, hardware that is locally available should be used.

Open-source software was used when possible, eliminating licensing as a recurring cost but requiring more training and technical skills to maintain.
Open-source software options should be selected over proprietary options to reduce costs and generate technologic capacity.
Political External funding covered the initial hardware and software costs. Obtaining external financial support to cover the initial investment required will make implementation more feasible.
Support at the provincial level was critical for engagement of field veterinarians. Garnering support at all levels of government is critical at the early implementation phase.

Engagement of key political stakeholders was essential to alleviate fears about potential for harm caused by novel types of surveillance data.
Early in the design process it is important to discern what the outputs of the system will be and their added value.
Ethical, societal, and cultural Government officials were initially concerned about data security. Build appropriate data security into all components of the system.
It was late in the implementation phase when government stakeholders recognized the potential for additional data uses. Examples of additional uses of data obtained will generate support for new surveillance initiatives.
At the onset of the project, field veterinarians were skeptical about the usefulness of data generated by the IDSAS. However, over time they envisaged how the outputs could be used in disease surveillance and in improving their daily veterinary duties. Adoption of novel surveillance methods requires user acceptance and new technical skills. Time and experience will enable this transition to occur.
Many farms are geographically isolated making access to field veterinarians difficult. Quality and quantity of data from surveillance systems are affected by the ability of an animal owner to access animal health services.

*IDSAS, Infectious Disease Surveillance and Analysis System.

Main Article

1These authors contributed equally to this article.

2Retired.

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