Digital Transformation of Tuberculosis Surveillance in Papua New Guinea: Scaling up Electronic TB Reporting in a Geographically Dispersed, High-Burden Setting

Abstract

Herolyn Nindil and Vivian Toanisa

Background: Papua New Guinea (PNG) is a high tuberculosis (TB) burden country with a substantial burden of rifampicin-resistant/multidrug-resistant TB. Its geographically dispersed population, including remote and hard-to- reach communities across 22 provinces, presents major challenges for health service delivery and disease surveillance. Historically, the National Tuberculosis Program (NTP) relied on paper-based reporting from Basic Management Units (BMUs), resulting in delayed and incomplete reports. In 2022, 24% of BMUs did not submit routine TB reports to the NTP. The objective of the electronic rollout of this study is to improve the timeliness, completeness, accessibility, and quality of routine TB surveillance through phased implementation of an electronic TB reporting system (e-TB) at BMU level.

Methods: The NTP introduced a web-based e-TB system enabling electronic TB data entry and submission using tablets or smartphones. Following a pilot in 2017, the system was progressively expanded across provinces and BMUs, supported by health-care worker training, refresher training, supportive supervision, and onsite technical assistance. Implementation data from 2017 to the first quarter of 2024 were reviewed.

Results: By the first quarter of 2024, e-TB had been rolled out in 13 of 22 provinces and 180 of 257 BMUs (70%). All participating BMUs had received e-TB training and were submitting quarterly reports electronically. Electronic reporting increased from 15 BMUs in 2017 to 180 by the first quarter of 2024. Reporting timeliness progressively improved following implementation, demonstrating the feasibility of transitioning from paper-based to electronic reporting despite geographical, infrastructure, logistical, and human resource constraints.

Conclusion: Digital TB surveillance is feasible in geographically dispersed, resource-constrained settings. Continued investment in connectivity, equipment, user capacity, supervision, data quality, and system maintenance is essential for nationwide coverage. The e-TB platform provides a foundation for integrated TB surveillance, commodity management, performance monitoring, and program governance.

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