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Pioneering training on “District Health Information System-2” to strengthen Integrated Disease Surveillance and Response System in laboratories in Sindh province of Pakistan

Pakistan has made significant success in strengthening the Integrated Disease Surveillance and Response (IDSR) system by implementing the digital platform District Health Information System (DHIS-2) for syndromic surveillance of priority communicable diseases. This first phase of IDSR has been rolled out across all public sector primary and secondary healthcare facilities in all 168 districts of the country.

Building on this foundation, the next phase of IDSR expansion focuses on integrating confirmed case reporting and establishment of IDSR labs networks at provincial and national level, as outlined in the national IDSR roadmap. This initiative paves the way for an effective disease detection, outbreak response, and public health planning.

In January 2025, the UK Health Security Agency (UKHSA) International Health Regulations Strengthening Project (IHR-SP) conducted Pakistan’s first ever DHIS-2 laboratory data capturing training in Karachi in collaboration with the National Institute of Health (NIH) Pakistan and the Provincial Health Department of Sindh. This two-day workshop marked a significant step in enhancing laboratory-based disease surveillance in the country.

A total of 100 laboratory personnel from 50 public sector laboratories across Sindh province, comprising 37 secondary care and 13 tertiary care laboratories were trained in two batches. These laboratories play a critical role in infectious disease surveillance within the public sector healthcare system. Each laboratory was represented by two participants, one either from the roles of pathologist, microbiologist or lab scientist, and the other a lab technologist, technician, or data entry operator. The training also included representatives from the Provincial Health Department, the Provincial Public Health Reference Laboratory (PPHRL) Sindh, and the NIH.

The primary objectives of the training were:

To enhance participants' understanding of the IDSR framework and its alignment with laboratory networks
To equip laboratory professionals with the skills to capture and visualise data using the DHIS-2 platform
To establish a system to integrate laboratory data into national disease surveillance system i.e. IDSR, enabling timely analysis, interpretation, and response to disease trends for effective public health decision-making

The training was inaugurated by senior Government officials from the Provincial Health Department and PPHRL. UKHSA IHR-SP’s in-country Microbiology Technical Adviser presented the key findings from the baseline assessment of public sector laboratories of Sindh province, providing context for the sessions ahead.

Participants received hands-on training on DHIS-2 functionalities, including data entry, data visualisation and dashboard navigation. The training featured interactive exercises, including dummy data entry and group presentations, ensuring practical learning. The training concluded with discussions on sustaining and scaling these efforts, led by NIH and Provincial Health Departments, followed by certificate distribution to participants.

IHR-SP’s commitment to taking action

At the end of session, UKHSA, the Provincial Health Department and NIH unanimously agreed to work methodically on key deliverables. The priority was to immediately initiate data capture in all trained labs from the subsequent week, followed by developing a mechanism to ensure the seamless flow of laboratory data. Additionally, it was decided to develop an analysis plan for laboratory data both for the Public Health Bulletin of Sindh province and the national IDSR weekly report These actions will help enhance disease early warning capabilities, improve response strategies, optimise laboratory operations, and ensure informed decision-making, ultimately strengthening national and global public health security.

This training represents a significant milestone in the journey to strengthen Pakistan’s disease surveillance systems by equipping public health laboratories with the tools and skills to efficiently capture and utilise data for evidence-based decision making and public health planning.