Strategic analysis of Iran's communicable diseases surveillance system in crises: A scoping review

The communicable disease surveillance system includes the collection, analysis, and interpretation of data related to communicable diseases to be used in planning, implementing, and evaluating public health policies and practices. Iran's communicable disease surveillance system (ICDSS) is facing numerous challenges. This research aimed to identify the strengths, weaknesses, opportunities, and threats of ICDSS and provide solutions to strengthen it.

The research was conducted using a scoping review method. Articles and documents on ICDSS published between 2000 and 2022 were searched using appropriate keywords in the electronic databases of PubMed, Scopus, Web of Science, Magiran, SID, Google, and Google Scholar search engines. Finally, 41 studies were selected and analyzed using MAXQDA software and the framework analysis method.

Strengths, weaknesses, opportunities, threats, and enhancement strategies to ICDSS were identified and grouped into five themes of the priority diseases targeted for surveillance, the structure of the surveillance system, core functions of the surveillance system, support functions of the surveillance system, and quality of the surveillance system. The most important strengths of ICDSS were the eradication of some infectious diseases, rapid implementation in critical situations, and high efficiency. The low motivation of employees, inefficiency of the reporting system in hospitals, and weak inter-departmental cooperation in prioritizing diseases were among the weaknesses. Using advanced diagnostic equipment and the increase of public awareness about infectious diseases are the main opportunities and population dispersion; the epidemy of infectious diseases in neighboring countries and the presence of immigrants in the country were the main threats to ICDSS. Solutions such as strengthening the infectious disease management center, integrating the CDSS into the family medicine program, integrating different parts of the surveillance system, regularly publishing the results, and creating an effective two-way feedback system were suggested for strengthening ICDSS.

Structures, processes, and core functions of ICDSS should be strengthened. Strategic analysis of ICDSS provides evidence to health policymakers to implement corrective interventions.