METHODS: ISSM was implemented on a rolling basis August-September 2015 in 18 out of 62 KD sections (“intervention sections”) reporting <25% of expected deaths per capita for seven months pre-intervention (calculated using population and age-adjusted mortality estimates); ISSM was not implemented in the remaining sections (“control sections”). Pre- and post-intervention per-capita weekly death reporting rates were calculated for each intervention section using ten weeks pre- and five weeks post-implementation period; control section rates were calculated using the neighboring section’s implementation date. The section-level reporting rate difference pre- versus post-implementation was averaged to compare intervention and control sections.
RESULTS: Following ISSM implementation, the death reporting rate increased across intervention and control sections; the rate difference pre- and post-intervention was not statistically significant between intervention and control sections. Two EVD deaths occurred in KD during the implementation period in sections pre-intervention, and generated 1 death alert. As of November 2015, no EVD cases or deaths occurred post-intervention.
CONCLUSIONS: ISSM did not significantly affect death reporting rates in KD. Unmeasurable benefits include increased community ownership of health. Limitations of the evaluation include small sample size and short sampling timeframe. Additional studies are recommended to further understand mortality surveillance needs.