Communicable Disease Notification Process and Performance: Insights from a Tertiary Healthcare Setting in Sri Lanka

Background: Disease notification is a crucial element of the notifiable disease surveillance system and plays a pivotal role in disease prevention and control. The routine surveillance system in Sri Lanka currently tracks over 25 medical conditions and is legally mandated to notify the health authorities. Notably, public tertiary health-care providers carry a substantial burden owing to the daily influx of communicable diseases, underscoring their crucial role in disease notification. However, the performance of disease notifications in tertiary care hospitals in Sri Lanka is not well understood.
Objective: This study aimed to assess the performance of a communicable disease notification process in a selected tertiary healthcare facility in Sri Lanka.
Methods: A mixed-method descriptive study approach was employed in a selected tertiary health care setting. The disease notification percentages in the ten most common communicable diseases cared for and notified from the 1st of January 2023 to the 30th of June 2023 were quantitatively assessed using the data gathered from hospital records. Performance was categorized as high, medium, or low, based on expert opinions. Empirical data on gaps in unsatisfactory notification performance were gathered via Focus Group Discussions and Key Informant Interviews. A thematic analysis was performed, and the causes of underperformance were revealed. Root causes were analyzed, and the most vital causes were identified through Pareto analysis. Suitable interven-tions were selected to address these causes.
Results: Among the 2368 diagnosed notifiable diseases, 64.4% (n = 1526) were diagnosed with dengue fever. Alarmingly, the notification percentages of seven out of ten diseases were low.  On average, 53.5% (n = 1266) of the total notifiable diseases were reported to the system, indicating medium performance. Key factors contrib-uting to this were insufficient knowledge and awareness among the healthcare staff regarding notification, gaps in monitoring, and lack of feedback.
Conclusions and Recommendations: The performance of communicable disease notifications in the selected tertiary healthcare facility was unsatisfactory. Mechanisms that sustainably enhance knowledge and awareness of notification, monitoring, and feedback can improve the situation.