IDSR Weekly Reporting in Kenya: What Facilities Need to Know
Reporting · 7 min read · Updated 2026-10-19
Integrated Disease Surveillance and Response (IDSR) is the system Kenya, along with most countries in the WHO African region, uses to detect outbreaks early. Every facility is a surveillance point. A cholera outbreak is first seen not by the Ministry but by the clinician who sees the third case of acute watery diarrhoea in a week.
IDSR only works if facilities report reliably, quickly and honestly, including when there is nothing to report.
Two kinds of reporting
Immediate reporting
Some diseases are reported immediately, as individual cases, without waiting for the weekly return. These are diseases where a single case can signal an outbreak or a public health emergency, such as cholera, measles, acute flaccid paralysis (suspected polio), anthrax, and viral haemorrhagic fevers. The current list is set by the Ministry's IDSR guidelines; keep the printed list at every clinical desk.
Weekly reporting
Every facility also submits a weekly summary of priority diseases, the MOH 505 weekly epidemic monitoring return, counting cases (and deaths) for each disease over the epidemiological week. It goes to the sub-county disease surveillance coordinator and into KHIS.
Zero reporting
The most misunderstood rule in IDSR: if you saw no cases, you report zero. A missing report and a report of zero mean very different things. A missing report says "we do not know". A zero says "we looked, and there were none". Surveillance depends on being able to tell the two apart, which is why completeness and timeliness of weekly reports are tracked as performance indicators in their own right.
Note that this is the opposite of the right practice on monthly service returns, where a service you do not collect should be left blank rather than reported as zero. The difference is that IDSR diseases are things every facility is expected to watch for.
Thresholds: from counting to warning
A weekly count only becomes surveillance when someone compares it with what is normal. IDSR uses alert and action thresholds:
- For some diseases a single case crosses the threshold.
- For others the threshold is a number of cases in a week, or a rise above the usual level for the time of year.
When a threshold is crossed, the facility notifies the sub-county, investigates, and records the response. On paper, thresholds are mostly checked in hindsight, when the weekly form is compiled. The value of doing it in software is that the check happens the moment the diagnosis is recorded.
What makes facility surveillance fail
- Diagnoses not coded. A case recorded as "diarrhoea" in free text may never be counted as suspected cholera.
- Reports compiled from memory at the end of the week.
- No named contact. An alert that goes to "the facility" goes to nobody.
- No closure. A breach that is noticed but never recorded as investigated is invisible to anyone reviewing the outbreak later.
How AfyaConnect handles IDSR
AfyaConnect counts the weekly return from coded diagnoses, so the report, the screen and the KHIS submission are the same number. Each notifiable disease has a threshold; the national defaults are loaded unconfirmed for the facility to confirm or adjust. When diagnoses cross a threshold a breach is raised immediately, escalated to the surveillance contacts the facility registers, and stays open until someone records the response. See KHIS and MOH reporting software, and our guide to the monthly MOH returns.