Health care providers' compliance with the notifiable diseases surveillance system in South Africa

Background The optimal performance of a notifiable disease surveillance system (NDSS) is dependent on health care provider (HCP) compliance with communicable disease notification. HCP compliance ensures appropriate investigation and control measures by relevant health care authorities. This study examines the compliance of HCPs with the NDSS in South Africa and factors associated with their compliance. Methods A cross-sectional survey was carried out in three randomly selected provinces. We stratified by type of facility, and recruited clusters of HCPs on survey day to participate. All consenting HCPs in the randomly selected health care facilities on the day of the survey, completed a questionnaire that elicited information on socio-demographic characteristics and notification practices. The data were analysed using STATA (R) 14, using the identifiers for stratum and cluster as well as the calculated sampling weights. Results The study found that 58% of 919 HCPs diagnosed a notifiable disease in the year preceding the survey. The majority of these professionals (92%) indicated that they had reported the disease, but only 51% of those notified the disease/s correctly to the Department of Health. Paediatricians were less likely to notify correctly (OR 0.01, 95% CI 0.00-0.12, p = 0.001). The factors that influenced notification were HCPs perceptions of workload (OR 0.84, 95% CI 0.70-0.99, p = 0.043) and that notification data are not useful (OR 0.84, 95% CI 0.71-0.99, p = 0.040). The study found no association between correct notification and HCPs willingness to notify, experience or training on the NDSS, understanding of the purpose of the NDSS, knowledge of what to notify, or perception of feedback given. Conclusions The compliance of HCPs in South Africa with the NDSS is suboptimal. In light of the important role of HCPs in the effective functioning of the NDSS, information on NDSS usefulness and guidelines on correct notification procedures are needed to increase their compliance.