Table 4. User survey, EWARS in a Box, Fiji, 2016.
| Survey question and responsesa | No. of usersb responding (%)c |
|---|---|
| Q. In which administrative division is the EWARS site located? | |
| Central, no. (% of all surveillance sites in division) | 12 (100) |
| Eastern, no. (% of all surveillance sites in division) | 2 (100) |
| Northern, no. (% of all surveillance sites in division) | 5 (50) |
| Western, no. (% of all surveillance sites in division) | 8 (80) |
| Total, no. (% of all EWARS sites in Fiji) | 27 (79) |
| Q. What do you think is the purpose of EWARS?d | |
| Theme: outbreak detection | 18 (67) |
| Theme: outbreak response | 9 (33) |
| Theme: general disease surveillance or monitoring | 12 (44) |
| Total respondents | 27 (100) |
| Q. How well do you think EWARS is able to signal an early warning for potential disease outbreaks? | |
| Very well | 18 (67) |
| Somewhat well | 7 (26) |
| Not very well | 2 (7) |
| Not at all well | 0 (0) |
| Total respondents | 27 (100) |
| Q. Do you think EWARS has had any impact on public health in Fiji? | |
| Yes | 20 (77) |
| No | 0 (0) |
| Unsure | 6 (23) |
| Total respondents | 26 (100) |
| Q. In your opinion, how easy is it to use EWARS on the mobile phone? | |
| Very easy | 24 (89) |
| Somewhat easy | 3 (11) |
| Not very easy | 0 (0) |
| Very difficult | 0 (0) |
| Total respondents | 27 (100) |
| Q. Have you ever had difficulty accessing EWARS on the mobile phone (e.g. application not working)? | |
| Unsure | 0 (0) |
| No | 12 (44) |
| Yes | 15 (56) |
| Total respondents | 27 (100) |
| Q. How often did you experience difficulty accessing EWARS?e | |
| Very often (most weeks) | 2 (13) |
| Somewhat often (> once a month) | 6 (40) |
| Not very often (≤ once a month) | 3 (20) |
| Not often (≤ twice during the study period) | 4 (27) |
| Total respondents | 15 (100) |
| Q. At your health facility, what is the process used to record patients who meet the case definitions? | |
| Medical officers record cases directly on the EWARS tally sheet at the time the patient is seen | 4 (20) |
| Medical officers record cases on an EWARS line list | 1 (5) |
| Weekly review of register or logbook by medical officer or nurse | 13 (65) |
| Not known | 0 (0) |
| Other | 2 (10) |
| Total respondents | 20 (100) |
| Q. How do you send/transmit the EWARS weekly reports?f | |
| EWARS mobile phone application | 25 (93) |
| EWARS website (using computer) | 1 (4) |
| 4 (15) | |
| Telephone call | 8 (30) |
| SMS | 6 (22) |
| Other | 3 (11) |
| Total respondents | 27 (100) |
| Q. What is your preferred reporting method? | |
| EWARS mobile phone application | 24 (92) |
| EWARS website (using computer) | 0 (0) |
| 0 (0) | |
| Telephone call | 2 (8) |
| SMS | 0 (0) |
| Total respondents | 26 (100) |
| Q. Have there been situations where you could not submit the EWARS weekly report on time (i.e. before 6 pm Monday)? | |
| Yes | 21 (88) |
| No | 3 (12) |
| Unsure | 0 (0) |
| Total respondents | 24 (100) |
| Q. What are the most common challenges for timely reporting?f | |
| Tally sheet not received on time from other staff | 11 (46) |
| No access to internet (no credit) | 4 (17) |
| No access to internet (no signal) | 11 (46) |
| No access to phone | 2 (8) |
| Not enough time/workload too heavy | 14 (58) |
| Unsure | 0 (0) |
| Other | 4 (17) |
| Total respondents | 24 (100) |
| Q. Are you aware of the EWARS case definitions? | |
| Yes | 27 (100) |
| No | 0 (0) |
| Unsure | 0 (0) |
| Total respondents | 27 (100) |
| Q. How easy is it to classify cases into the syndrome categories? | |
| Very easy | 11 (41) |
| Somewhat easy | 16 (59) |
| Not very easy | 0 (0) |
| Very difficult | 0 (0) |
| Total respondents | 27 (100) |
| Q. How easy was it to amend the reporting process when an additional syndrome (i.e. Zika-like illness) was added to EWARS? | |
| Very easy | 12 (44) |
| Somewhat easy | 13 (48) |
| Not very easy | 2 (7) |
| Not at all easy (very difficult) | 0 (0) |
| Total respondents | 27 (100) |
| Q. Why was it not easy? | |
| Theme: similar case definitions and patient presentation | 2 (100) |
| Total respondents | 2 (100) |
| Q. Did you receive any feedback when an EWARS alert was generated for your health facility? | |
| Yes | 22 (81) |
| No | 3 (11) |
| Unsure | 1 (4) |
| Not applicable | 1 (4) |
| Total respondents | 27 (100) |
| Q. Do you receive the EWARS weekly bulletin? | |
| Yes | 19 (70) |
| No | 7 (26) |
| Unsure | 1 (4) |
| Total respondents | 27 (100) |
| Q. How useful is the information in the EWARS weekly bulletin for your health facility? | |
| Very useful | 9 (33) |
| Somewhat useful | 12 (44) |
| Not very useful | 3 (11) |
| Not at all useful | 3 (11) |
| Total respondents | 27 (100) |
| Q. How have you used the information in the EWARS weekly bulletin? | |
| Theme: information sharing | 6 (32) |
| Theme: to compare with other reporting areas | 5 (26) |
| Theme: to initiate preventive or responsive public health actions | 5 (26) |
| Total respondents | 27 (100) |
| Q. How could the EWARS weekly bulletin be improved?d | |
| Theme: include health facility-specific surveillance data | 3 (16) |
| Theme: include outcome of the previous week's case investigations | 1 (5) |
| Theme: extend access to other staff members at the health facility | 2 (11) |
| Total respondents | 19 (100) |
| Q. Do you ever distribute the information in the weekly bulletin to other persons or organizations? | |
| Yes | 9 (35) |
| No | 16 (62) |
| Unsure | 1 (4) |
| Total respondents | 26 (100) |
| Q. Who do you distribute the information to?f | |
| Theme: health facility colleagues | 8 (89) |
| Theme: community health-care workers | 3 (33) |
| Theme: regional public health staff | 1 (11) |
| Total respondents | 9 (100) |
| Q. How satisfied do you feel with the training that you received when EWARS was implemented? | |
| Very satisfied | 11 (41) |
| Somewhat satisfied | 12 (44) |
| Not very satisfied | 3 (11) |
| Not at all satisfied | 1 (4) |
| Total respondents | 27 (100) |
| Q. How supported do you feel to be able to carry out your EWARS responsibilities? | |
| Very supported | 13 (48) |
| Somewhat supported | 14 (52) |
| Not very supported | 0 (0) |
| Not at all supported | 0 (0) |
| Total respondents | 27 (100) |
| Q. Overall, how satisfied are you with EWARS? | |
| Very satisfied | 16 (59) |
| Somewhat satisfied | 11 (41) |
| Not very satisfied | 0 (0) |
| Not at all satisfied | 0 (0) |
| Total respondents | 27 (100) |
EWARS: early warning, alert and response system; Q: question; SMS: short message service; WHO: World health Organization.
a For confidentiality reasons, qualitative data is not reported.
b Users were people who submitted EWARS data (i.e. site focal points or individuals in charge of surveillance sites).
c All values in the table represent the absolute number of users responding to the specific question and the percentage of the total responding to the question, unless otherwise stated.
d This was an open question and answers were grouped thematically.
e This question was asked to those respondents who answered yes to the preceding question.
f Respondents were permitted to give more than one response to this question.