Determinants of Integrated Disease Surveillance and Response Implementation among Healthcare Workers: A Scoping Review

Abstract Background: Integrated Disease Surveillance and Response (IDSR) has been adopted by 42 of 47 WHO African member states, yet facility-level implementation remains suboptimal. Healthcare worker performance is shaped by individual, organisational, and system-level determinants that remain incompletely characterised. Objective: This scoping review mapped and synthesised evidence on determinants of IDSR implementation among healthcare workers globally, with attention to Nigerian and northeastern Nigerian evidence and the extent of comparative evidence across facility levels. Methods: The review followed the Arksey and O'Malley (2005) framework, refined by Levac et al. (2010), and followed PRISMA-ScR guidance (Tricco et al., 2018); no protocol was registered. PubMed, CINAHL, Web of Science, and Google Scholar were searched for records published from January 2015 to May 2025 (final search April 2026), supplemented by hand-searching for foundational pre-2015 sources. Screening and extraction were conducted by the primary author. Sixteen studies met inclusion criteria. Results: Five determinant categories were commonly reported: knowledge deficits in case definition and reporting, inadequate training coverage, resource constraints, supervisory dysfunction, and feedback failure. A knowledge-practice dissociation was reported in Nigerian studies, suggesting knowledge deficits alone do not account for implementation failure. No study compared implementation between primary and secondary healthcare workers, and peer-reviewed evidence from northeastern Nigeria was limited, with none identified for Bauchi State. Conclusion: Existing evidence suggests IDSR implementation barriers are prevalent and broadly consistent across contexts, but the evidence base is methodologically insufficient to explain mechanisms of failure or guide tier-specific interventions. A formal comparative assessment in Bauchi State is warranted.