idsp-PPT.pptx integrated disease surveillance programme

integrated disease surveillance programme to integrated disease information platform

1. INTEGRATED DISEASE SURVEILLANCE PROGRAMME(IDSP) Presented by: Dr Swapna Moderator : Dr Mrudula

2. Learning objectives By the end of the session able to understand about IDSP and S,P,L forms To demonstrate IHIP To learn difference between IDSP and IHIP

3. History Introduction of IDSP Objectives of IDSP Organization structure Key features of IHIP Diseases under IDSP and IHIP Data flow of IHIP Differences between IDSP & IHIP SWOT analysis Conclusion References contents

4. History 1997-98: National Surveillance Program for Communicable Diseases (NSPCD) 2004: World bank funded Integrated Disease Surveillance Project (IDSP) 2007-08: IDSP as a part of National Rural Health Mission (NRHM) 2012-17: A pproved as “Integrated Disease Surveillance Programme ” 2018: Phased integration and implementation of IHIP

5. What is Public health surveillance? Public health surveillance (also epidemiological surveillance, clinical surveillance or  syndromic surveillance) is, according to the  World Health Organization   (WHO), "the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of   public health   practice.“ Public health surveillance may be used to track emerging health-related issues at an early stage and find active solutions in a timely manner

6. INTEGRATEDI Integrated Disease Surveillance Programme Integrated Disease Surveillance Programme (IDSP) was launched with World Bank assistance in November 2004 to detect and respond to disease outbreaks quickly. Detect early warning signals of impending outbreaks & help initiate an effective response in a timely manner Provide essential data to monitor progress of on-going disease control program and help allocate health resources more efficiently

7. Objectives of IDSP Integration and decentralization of surveillance activities through establishment of surveillance units at Centre, State and District level. Human Resource Development. Information Communication Technology - for collection, collation, compilation, analysis and dissemination of data. Strengthening of public health laboratories.

8. The project was extended for 2 years in March 2010 i.e. from April 2010 to March 2012, World Bank funds were available for Central Surveillance Unit (CSU) at NCDC & 9 identified states (Uttarakhand, Rajasthan, Punjab, Maharashtra, Gujarat, Tamil Nadu, Karnataka, Andhra Pradesh and West Bengal) and the rest 26 states/UTs were funded from domestic budget. The Programme continues during 12th Plan (2012-17) under NHM.

9. Surveillance units have been established in all states/districts (SSU/DSU). Central Surveillance Unit (CSU) established and integrated in the National Centre for Disease Control, Delhi. Training of State/District Surveillance Teams and Rapid Response Teams (RRT) has been completed for all 35 States/UTs. IT network connecting 776 sites in States/District HQ and premier institutes has been established with the help of National Informatics Centre (NIC) and Indian Space Research Organization (ISRO) for data entry, training, video conferencing and outbreak discussion.

10. Under the project weekly disease surveillance data on epidemic prone disease are being collected from reporting units such as sub centers, primary health centers, community health centers, hospitals including  government and private sector hospitals and medical colleges.  The data are being collected on ‘S’ syndromic; ‘P’ probable; & ‘L’ laboratory formats. The weekly data are analyzed by SSU/DSU for disease trends. Whenever there is rising trend of illnesses, it is investigated by the RRT to diagnose and control the outbreak.

11. Key aspects of an RRT in a District Surveillance Unit: Outbreak Investigation: RRTs are deployed when there's a rising trend of illnesses in a specific area to investigate the cause and extent of the outbreak.  Multi-Specialty Team: Typically, an RRT includes an epidemiologist, a clinician, and a microbiologist, and may include other specialists as needed,  according to the Integrated Disease Surveillance Programme (IDSP) .  Prompt Action: Upon receiving information about an outbreak, the RRT acts swiftly to implement preventive measures and control the situation. 

12. Coordination: RRTs work closely with the District Surveillance Unit, State Surveillance Units, and other relevant stakeholders to ensure a coordinated response.  Disease Control: The main goal is to diagnose the disease, implement control measures, and prevent further spread of the outbreak. 

13. Strengthening Surveillance: RRTs are a key element in strengthening the overall disease surveillance system within a district.  Specific Tasks: These may include contact tracing, containment planning, and providing support to the district administration in outbreak situations.

14. A 24X7 call center was established in February 2008 to receive disease alerts on a Toll Free telephone number (1075). The information received is provided to the States/Districts surveillance Units for investigation and response. The call center was extensively used during H1N1 influenza pandemic in 2009 and dengue outbreak in Delhi in 2010. 2,77,395 lakhs calls have been received from beginning till 30th June, 2012, out of which 35,866 calls were related to Influenza A H1N1. From November 2012, a total of 50,811 calls received till November 2013 out of which 1499 calls were related to H1N1.

15. District laboratories are being strengthened for diagnosis of epidemic prone diseases. These labs are also being supported by a contractual microbiologist to mange the lab and an annual grant of Rs 2 lakh per annum per lab for reagents and consumables.

16. In 9 States, a referral lab network has been established by utilizing the existing 65 functional labs in the medical colleges and various other major centers in the States and linking them with adjoining districts for providing diagnostic services for epidemic prone diseases during outbreaks. Based on the experience gained, the plan will be implemented in the remaining 26 States/UTs. A total of 23 identified medical college labs in Bihar, Assam, Odisha, Tripura, Kerala, Haryana, Jammu & Kashmir and Manipur has been added to the network during 2012-13 to provide support in adjoining districts.

17. Incorporation of Public sector, private sector & community participation Communicable and Non-communicable disease Rural and urban health system Government and Private medical college Various international health agencies like WHO, CDC NIH etc.

18. Organisation Structure Central Surveillance Unit (CSU):  Integrated administratively and financially with National Centre for Disease Control (NCDC), Delhi State Surveillance Unit (SSU):  One in each State/UT with a regular officer identified as State Surveillance Officer (SSO). Supported by 7 contractual staff. District Surveillance Unit (DSU):  One in each district with a regular officer as District Surveillance Officer (DSO). Supported by 3 contractual staff

19. Type of Disease Surveillance under IDSP Type Definition Responsibility Type of Form

20. Diseases under Surveillance: Presumptive (P Form) 1 Acute Diarrhoeal Disease (including acute gastroenteritis) 2 Bacillary Dysentery 3 Viral Hepatitis 4 Enteric Fever 5 Malaria 6 Dengue / DHF / DSS 7 Chikungunya 8 Acute Encephalitis Syndrome 9 Meningitis

21. 10 Measles 11 Diphtheria 12 Pertussis 13 Chicken Pox 14 Fever of Unknown Origin (PUO) 15 Acute Respiratory Infection (ARI) / Influenza Like Illness (ILI) 16 Pneumonia 17 Leptospirosis 18 Acute Flaccid Paralysis < 15 Years of Age 19 Dog bite 20 Snake bite 21 Any other State Specific Disease (Specify) 22 Unusual Syndromes NOT Captured above (Specify clinical diagnosis

22. Diseases under Surveillance: Laboratory Confirmed ( LForm ) 1. Dengue / DHF / DSS 2. Chikungunya 3. JE 4. Meningococcal Meningitis 5. Typhoid Fever 6. Diphtheria 7. Cholera 8. Shigella Dysentery 9. Viral Hepatitis A 10. Viral Hepatitis E 11. Leptospirosis 12. Malaria  PV:  PF:

23. Information flow of the weekly surveillance system Sub-centers P.H.C.s C.H.C.s Dist. hospital Programme officers Pvt. practitioners D.S.U. Med. college Other Hospitals: ESI, Rly., Army etc. S.S.U. C.S.U. Nursing homes Private hospitals Private labs. Corporate hospitals

24. Need for IHIP Joint Monitoring Mission, 2015 recommended review and re-designing the IDSP surveillance system Re-prioritization of the list of diseases under IDSP Integration of other diseases surveillance platforms As part of IHR core capacity building, India needs a comprehensive information system. IHIP provides information on health surveillance from anywhere on any electronic device .

25. IHIP Recent development in the already existing IDSP Launched by the Ministry of Health & Family Welfare Revolutionize digitalization of health sector in India. Soft launched on a Pan-India basis from 1 st April 2021 IHIP is a real-time, web-based platform which provides information on health surveillance from anywhere on any electronic device

26. All data contained in IHIP has the public health surveillance attributes: (time, place & person) All data are geocoded for geographic reference. The design & development of this platform are attributed to the strengthening of India’s Public Health Surveillance System

27. Key features of IHIP Real time data reporting , accessible at all levels GIS -enabled graphical representation of data into an integrated dashboard Geo-tagging of reporting health facilities Role & hierarchy-based feedback mechanism Scope for data integration with other health programs

28. Data will be provided in real-time through: Grass root Healthcare workers through their gadgets (Tablets/ mobile) Doctors at the PHC/CHC/DH when the citizens seek healthcare Diagnostic labs which will provide data of the tests carried out

29. Block PHC or Community Health Center Sub Center or Health Sub center Primary Health Center District Surveillance Unit State Surveillance Unit Broadband Connectivity Broadband and Satellite-based Connectivity State (36 States /UTs) District (707) Sub-district (6267) Village ( 655075 ) PH-EOC 24-HOUR CALL CENTER Broadband Connectivity Portal access Mobile Reporting Mobile reporting Portal access Mobile Reporting Portal access Mobile Reporting Proposed System : Portal access allows reporting of all data from DSU, CSU, SSU to CSU/IDSP in near real-time. Mobile reporting is both store and forward and near real-time. Data analytics and results will be accessible at all levels for action. Laboratory Presence Laboratory Presence New IHIP real-time data flow process Primary Health Center Community Health Center Laboratory Presence

30. Requirements for data reporting Working computer systems & regular internet connectivity Adequate manpower trained for IHIP at every level Proper mechanism to capture & record the requisite data for entering into IHIP including mandatory fields

31. Data reporting on IHIP

32. Step-I : Verification of master data of health facility Examination of user IDs and password Creation of user profiles Creation of health facility directory

33. A) Examination of User IDs & Password Cross-check whether the User ID and password for each health facility have been received or not [https://ihip.nhp.gov.in/#!/] Check the functionality of each User ID & Password After logging in, confirm that the appropriate form (S, P & L) & and relevant user access have been provided

34. B) Creation of User Profiles T o identify the user/personnel associated with the User IDs To get details of the password, in case it is forgotten Fill in relevant details in the user profile Name Age Gender Contact details

35. Account Sr. No Type of User User profile details Health facility 1 Sub Centre ANM or whoever is doing S form entry 2 Primary Health Center (P Form) Medical Officer I/c (In-charge) or whoever is doing P form entry 3 Primary Health Center (L Form) Medical Officer I/c (In-charge) or whoever is doing L form entry or Lab technician 4 Other health facilities (P Form) e.g. CHC, SDH, DH, MCH In-charge of health facility or official designated for P form data collection (Physician) or whoever is doing P form entry 5 Other health facilities (L Form) e.g. CHC, SDH, DH, MCH In-charge of health facility or official designated for L form data collection (Microbiologist/ Lab technician) or whoever is doing L form entry Administrative office 6 Block (Sub-district)* Block Health officer 7 District District Surveillance Officer 8 State State Surveillance Officer B) Creation of User Profiles ( Cont …)

36. C) Creation of a health facility directory Cross-check the total number of health facilities & their different types as available in the IHIP vs that actually existing in the State in terms of numbers & types Examine & cross-check the mapping PHC to SCs SC to Villages

37. C) Creation of Health facility directory ( Cont …) Health facility details including name, mobile, landline, and email ID of officer in charge of health facility need to be updated from “ edit/update health facility ” option Health facility can update Essential medicine list, emergency medicine list, equipment supplies, health workforce details and can also request new user IDs for health facility

38. Account Sr. No Health Facility (type of user) Officer In-charge details Health facility 1 Sub centre (S form user) Medical Officer In-charge of the PHC to which the Health Sub Center belongs 2 Primary Health Center (P Form user) Medical Officer In-charge of the PHC 3 Primary Health Center (L Form user) Medical Officer In-charge of the PHC 4 Other health facilities (P Form user) e.g. CHC, SDH, DH, MCH etc. In-charge of health facility or official designated as Nodal person for IDSP 5 Other health facilities (L Form user) e.g. CHC, SDH, DH, MCH etc. In-charge of health facility / lab or official designated as Nodal person for IDSP Administrative office 6 Block (Sub-district)* Block Health officer 7 District(DSO user &District admin user) District Surveillance Officer 8 State (SSO user &State admin user) State Surveillance Officer C) Creation of Health facility directory ( Cont …) *to be issued yet

39. C) Creation of Health facility directory ( Cont …) State and District user need to check different types & numbers of health facilities available in IHIP through health facility dashboard from Administration menu State and District user can add new health facility / add new RRT / update health facility details / delete health facility through Administration Module

40. S form entry (Android app) ‘ http://ihip.nhp.gov.in/idsp/downloadapk ’

41. IHIP portal https://ihip.mohfw.gov.in/#!/

42. Desktop version: L form entry https://ihip.nhp.gov.in/idsp/#!/login

43. Desktop version- EWS form entry https://ihip.nhp.gov.in/idsp/#!/login

44. Differences between previous and new IDSP portal IDSP IHIP Capture aggregated data only Paper-based data collection No linkage of data from S, P & L forms Weekly surveillance reporting Monitor only 22 health conditions Data not geocoded Capture disaggregat e data (by age, gender and locality) of persons at all levels Electronic collection and transmission of data Links data from S, P, L, EWS forms Real-time or daily surveillance reporting Monitor >33 health conditions Data geocoded for geographical reference

45. SWOT analysis OPPORTUNITIES -Better surveillance coverage
-Improved continuous monitoring Creation of ABHA ids -Revamp public-private partnerships
-Enable evidence-based policymaking THREATS - Individual data portals for different programs -Low doctor-patient ratio or the health worker-patient ratio -Delay to get approval from the state for the constitution of a RRT(rapid response team)

46. CONCLUSION Integrating IHIP with IDSP has, for collecting and analyzing health-related data helps To facilitate better continuity of care and diagnosis and prevention of epidemic-prone diseases Aids in changing the pace of data collection with real-time monitoring Proper utilization of infrastructure and resources Strengthened disease surveillance and response activities by providing a centralized platform

47. REFERENCES Tanu T, Sagar V, Kumar D. IHIP - A Leap into India's Dream of Digitalizing Healthcare. Indian J Community Med. 2023 Jan-Feb; 48(1):201. doi : 10.4103/ijcm.ijcm_739_22. Epub 2023 Feb 1. PMID: 37082408; PMCID: PMC10112761. idsp.mohfw.gov.in Disesase , I., Programme , S., Of, S., 2018. Guidelines for soft launch of integrated disesase surveillance programme segment of integrated health information platform. Blanchard J; Washington R; Becker M; Vasanthakumar N; Madangopal K; Sarwal R. et al. Vision 2035: Public Health Surveillance in India. A White Paper. NITI Aayog. December 2020. Blanchard, James, Reynold Washington, Marissa Becker, Vasanthakumar Namasivayam , K Madan Gopal, and Rakesh Sarwal. 2021. Vision 2035 Public Health Surveillance in India - A White Paper. figshare . https://doi.org/10.6084/M9.FIGSHARE.14093323

48. THANK YOU

49. Conditions listed under IHIP