Table 3 Barriers to case reporting at the practitioner and government/public sector end as identified by the studies

A

Barriers to reporting: practitioner end

n %

1

Lack of information what, how, where to report /unfamiliarity on reporting process/system [15, 16, 30, 33, 37, 49, 51, 53]

8 (20%)

2

Motivation [11, 14, 51, 59] and lethargy [15]

5(12.5%)

Should be financially reimbursed [15, 27]

2 (5%)

Disease reporting not considered a priority [51]

1 (2.5%)

3

Patient confidentiality [14, 15, 30, 34, 37, 53, 56]

8 (20%)

Legal issues [14, 15, 33, 51]

4 (10%)

Complicated reporting systems [37, 51, 53]

3 (7.5%)

Fear of losing patients [16, 28]

2 (5%)

Beyond scope of clinicians responsibilities /No obvious benefit [11, 51]

2 (5%)

Misconception about reporting procedures [30]

1 (2.5%)

Appear foolish if misdiagnosed [15]

1 (2.5%)

Fear notification may trigger further investigations [15]

1 (2.5%)

4

Infrastructure issues such as human (adequate and skilled, staff turnover) resources and equipment resources [14, 17, 27, 31, 32, 48, 50, 51, 58]

9 (22.5%)

Lack of time/additional burden [14,15,16,17, 33, 34, 53]

7 (17.5%)

Lack of reporting forms/registers [15, 37] impractical design [15]

3 (7.5%)

No lab or technician [11, 26, 48]

3 (7.5%)

Cost of reporting [59]

1 (2.5%)

B

Barriers to reporting: government and public sector end

n %

Lack of clear instructions/inadequate dissemination of guidelines/no assistance with reporting procedures, supervision or feedback etc. [14, 22, 24, 33, 34, 43, 46, 48, 51]

9 (22.5%)

Lack of cooperation/coordination/collaborative environment/positive dialogue (Govt. and private sectors) [14, 22, 30, 37, 46, 48, 51]

7 (17.5%)

Lack of leadership/strong and proactive administration [28, 31, 34, 48, 55, 59]

6 (15%)

No punitive action or regulation [11, 22, 30, 53] (separate regulatory function from service provision [27])

5 (12.5%)

Non-involvement of range of private healthcare providers [11, 22, 27]

3 (7.5%)

Other (Red tapism [33], lack of simplified system [37]

2 (5%)