Table 1. Attributes of EWARS in a Box evaluated after Cyclone Winston, Fiji, 2016.
| EWARS attribute | Criterion | Data sources |
|---|---|---|
| Surveillance quality | ||
| Timelinessa | Submission of data on time (i.e. by the Monday following the week under surveillance, which lasted from Monday to Sunday) | EWARS database and cross-sectional survey of EWARS usersb |
| Completenessa,c | Submission of data by Sunday of the week following the week under surveillance | EWARS database and cross-sectional survey of EWARS usersb |
| Data validitya,c | Accuracy of the data recorded by the surveillance system | EWARS database, surveillance site visits and retrospective reviews of clinic records |
| Representativeness | Geographical appropriateness and coverage | Review of implementation protocol, EWARS database, population data from Fiji’s Ministry of Health and Medical Services and stakeholder interviews |
| System performance | ||
| Usefulnessa,c | EWARS’ contribution to monitoring disease trends and the early detection of disease clusters and outbreaks | Cross-sectional survey of EWARS usersb |
| Flexibilitya,c | Ability to adapt rapidly to changing information needs or operating conditions without substantial demands on staff or funding | Cross-sectional survey of EWARS usersb and stakeholder interviews |
| Simplicitya,c | Ease of use of surveillance system | Cross-sectional survey of EWARS usersb |
| Acceptabilitya,c | Willingness of users to participate in surveillance and data collection and analysis | Cross-sectional survey of EWARS usersb |
| Stability | Reliability and resilience of EWARS | EWARS database and cross-sectional survey of EWARS usersb |
| Cost | Expenditure on equipment and on implementing and operating the system | Fiji Ministry of Health and Medical Services, Fiji Health Sector Support Program and WHO Division of Pacific Technical Support |
EWARS: early warning, alert and response system; WHO: World health Organization.
a This attribute was evaluated only for indicator-based surveillance.
b EWARS users were people who submitted data to the system (i.e. surveillance focal points or individuals in charge of surveillance sites).
c For reasons of confidentiality, qualitative data are not reported.