Republic of the Congo// — When residents in Birim North District began reporting an unusually high number of deaths among pigs, the reports did not remain at the community level.
They triggered investigations involving the Ghana Health Service (GHS), Veterinary Services Directorate, Environmental Health Department and other local government agencies.
The response demonstrated an important principle of public health preparedness: unusual events are often first noticed in communities, and the ability to report and investigate these signals quickly can help authorities identify potential threats before they escalate.
To strengthen early warning and investigation capacity, the World Health Organisation (WHO), through the Pandemic Fund Project, supported the Ghana Health Service (GHS) to strengthen Event-Based Surveillance (EBS) in nine districts across three regions. These were Atwima Kwanwoma, Obuasi East and Offinso North in the Ashanti Region; Ayensuano, Birim North and Kwahu Afram Plains North in the Eastern Region; and La Dade-Kotopon, Kpone Katamanso and Shai Osudoku in the Greater Accra Region.
Event-Based Surveillance complements Ghana’s Indicator-Based Surveillance system by helping health authorities identify and act on unusual events that may not yet appear in routine health-facility data.
Under the intervention 551 people were trained across nine districts, comprising 271 health and multisectoral personnel and 280 community informants. The participants included community health nurses, disease control officers, medical officers, general and public health nurses, physician assistants, environmental and veterinary health officers, health promotion and information officers, laboratory personnel and School Health Education Programme Coordinators.
The training equipped community members and stakeholders to detect unusual events through community, health facility and media channels, and report same to the health system through designated platforms and pathways. Healthcare staff were also trained to triage, verify and assess reported signals. Participants were also introduced to reporting through SORMAS, multisectoral coordination and supportive supervision to strengthen the sustainability of EBS.
The impact of the intervention is already being seen in the participating districts.
Following the trainings, districts reported an increase in signals received from communities, greater awareness of events that could indicate public health threats, and stronger collaboration among health, veterinary, emergency management and local government actors.
The experience in Birim North District provides a practical example.
Reports of the unusually large number of pig deaths prompted relevant authorities to investigate and coordinate a response.
The involvement of multiple sectors demonstrated how a functioning early-warning system can connect a community-level alert with the technical expertise and institutions needed to assess and respond to a potential public health threat, highlighting a One Health approach to health threat detection and response.
For Ms Annet Akpene Asraku, Eastern Regional Surveillance Officer, the change has been particularly significant.
“The region was faced with inadequate and late reporting of unusual events from the communities. However, the EBS training has equipped participants with the knowledge and skills to report from the community level. The community structures are now on the alert and are reporting to the health system, thanks to WHO’s support”, she said.
The experience demonstrates that effective early warning is not only about surveillance systems and technology. It depends on people being able to recognise unusual events, knowing where and how to report them, and having a health system capable of acting on those alerts.
For WHO and GHS, strengthening EBS at the community level is therefore about building a stronger link between the first signal and the first response. With trained community informants, frontline health workers and multisectoral actors now better equipped to detect, report and investigate unusual events, the intervention is helping Ghana strengthen an early-warning system that starts where public health threats may first emerge—the community.
