Skip to content
INSIGHT Surveillance Toolkit

Conduct

Legal and Regulatory Framework Assessment

Departments within the three primary ministries (Health, Agriculture, Environment) were assessed for both public health surveillance and data sharing intersection. The Assessment Team reviewed over 190 decrees, norms, policies, regulations, plans, guidelines, and reports to determine where surveillance and data sharing was included in legislation across every level of government and across multiple ministries using publicly available government resources and through interviews with key stakeholders. While the focus was initially on the Ministries of Health, Environment, and Animals, the assessment found many other ministries and departments that had legislation embedded for either surveillance or data sharing.

Surveillance System Assessment

Data Collection Training

The Assessment Team trained data collectors to conduct the assessment for three days in Lima. The training included practical skills in methods of the situational analysis, obtaining informed consent, using the data collection tools, interviewing practice, and data storage. On the final day of training, the data collection team conducted a pilot of the tool at a local health facility in Lima and reviewed logistics for the site visits.

Situational Analysis Training

Survey Implementation

A total of 283 participants were interviewed either in person (213) or virtually (70) between July 18, 2022, through September 26, 2022. Skip patterns allowed for specific questions targeted to respondent role. Most respondents were from the MINSA, followed by the Ministry of Agrarian Development and Irrigation (MIDAGRI), Regional Governments, and private or other entities. Participants signed an electronic informed consent form and were sent a copy if requested. Qualitative questions were recorded in the audio feature of KoboToolbox. Data was uploaded to a database daily. A data manager reviewed the forms to ensure that the surveys were completed based on standard operating procedures. Any errors were communicated back to the team for resolution.

Surveillance Data Assessment

Datasets were identified by CDC-Peru and the assessment team for inclusion in the analysis of the seven priority pathogens. The data sources utilized for the analysis of the pathogens of interest included:

  • NotiWeb: Indicator-based surveillance data from CDC Peru
  • Health Information System (HIS): Outpatient surveillance data from health facilities reporting to MINSA
  • Sistema Informático Nacional de Defunciones (SINADEF): Individual-level data from the national electronic death certificate system
  • Sistema Nacional de Sanidad Agraria (SENASA): Animal health data system
  • Peru’s open data platform: Open databases for COVID-19 related surveillance in Peru

For NotiWeb and HIS, all cases of the selected diseases from January 1, 2011, to August 20, 2022, were included. This included patients of all ages for every disease, except acute respiratory infections (ARIs) which only included children under 5 years of age because they are the target population for surveillance. The Assessment Team included all cases registered from January 1, 2017, through June 5, 2022 from the SINADEF database, which was established in 2017 so the full datasets in the database were extracted. For SENASA, all cases of rabies, brucellosis, and leptospirosis registered from January 1, 2011, to December 31, 2021, were included. Date ranges were included in the analysis to reflect the full data from outpatient clinics, NotiWeb (national case-based notification system), NetLab (laboratory information system).

The datasets used for COVID-19 were identified through a targeted search on Peru’s Open Data Portal. The team specifically filtered for datasets related to COVID-19 surveillance to ensure they 1) included relevant information about public health surveillance, and 2) contained data that could, in some instances, be linked between datasets.

  • COVID-19 Deaths: This dataset is part of Peru’s vital registration system, SINADEF, containing patient-level data on COVID-19-related deaths. The dataset was chosen due to the high burden of COVID-19-related deaths in Peru.
  • Molecular Tests: Registered in the national laboratory system, NetLab, each row represents a test and includes both positive and negative PCR test results. This dataset was selected to assess testing efforts in Peru.
  • Positive Tests: Sourced from the Peruvian CDC via their SISCOVID system, it contains only positive tests from any diagnostic method (e.g., PCR, antigen, or serological tests).
  • Triage: This dataset includes calls from the 113 telephone line designated for suspected COVID-19 cases.
  • Hospitalized Patients: Also reported through the SISCOVID system, this dataset contains information about patients who have been hospitalized.

Interoperability Assessment

To assess the status of interoperability of the different public health data streams in Peru, a team member with expertise in informatics extracted information from survey interview about systems, technologies and details related to system interoperability. This information, along with the existing policies, standards, and regulations for Digital Government existing in Peru, was used to build a data flow map depicting the types of information exchanged between systems, the transport protocols and APIs used to exchange these data, and whether this exchange required manual data entry or was completed automatically.

Historical efforts toward health information exchange in the Peru context were also summarized and compared with best practices for public health informatics and One Health data integration, to further identify opportunities for improved interoperability at the data exchange and process levels. This was done through reviewing public documentation from the Secretariat of Government and Digital Transformation and other ministries, as well as legislation, regulations, and previously published studies.

Next: Analyze

Previous: Plan

Skip to toolbar