Neonatal Mortality Surveillance System Evaluation, La-Nkwantanang Municipal Assembly, Greater Accra Region, Ghana, 2015-2019

Introduction: Neonatal mortality occurs during the first 28 days of life and in Ghana, the rate is 25 per 1000 live births. Regular evaluation of disease/event surveillance systems is required to ensure they are meeting their objectives and serving the public health mission. Therefore, we evaluated the newborn mortality surveillance system's attributes and usefulness. Methods: This study analyzed the La Nkwantanang Neonatal Mortality Surveillance System from 2015 to 2019 using systematic extraction of weekly and monthly reports, case-based forms and facility data sets. Stakeholders were interviewed and pertinent documents were used to evaluate the system's usefulness and attributes such as simplicity, data quality, acceptability, representativeness, timeliness, and stability. Results: During the period 2015 to 2019, the district reported 17 neonatal deaths with 88% (15) of these not being fully audited. The neonatal mortality surveillance system is integrated into the national IDSR reporting system. Data quality is low as only 47% (14/30) of the health facilities are reporting, with a considerable disparity in reported figures between levels of the system. There is low participation from private health facilities (9/25) due to delayed or no reporting. However, the District Health Information System version 2 offline mode allowed data input when the internet is unavailable. The system allows additional features without disruptions. Conclusion: The objectives of the neonatal mortality surveillance system are partially being achieved. Although data is being used for policy formulation, audits are not fully conducted.