SURVEILLANCE AND MONITORING.pptx

Surveillance and monitoring

1. SURVEILLANCE AND MONITORING

2. CONTENTS Introduction Uses of surveillance Types of surveillance Surveillance in practice Sources of data Factors that influence the effectiveness of surveillance data Monitoring Health information system

3. Introduction SURVEILLANCE French word sur meaning over Veiller TO WATCH Best weapon to avert epidemics

4. Health surveillance Definition : The ongoing systematic collection, analysis and interpretation of health data essential for planning, implementing and evaluating public health activities. Include : - Compulsory notification regarding specific diseases, - Specific disease registries (population-based or hospital-based) - Continuous or repeated population survey - Aggregate data that show trends of consumption patterns and economic activity.

5. Uses of Surveillance

6. Uses of surveillance Plan and provide care Strengthen commitment Mobilise communities Advocate for sufficient resources

7. Categories of uses of public health surveillance according to the world bank Assess the public health impact of health events or determine and measure trends Demonstrate the need for public health intervention programs and resources and allocate resources during public health planning

8. Monitor the effectiveness of prevention and control measures and intervention strategies Identify high-risk population groups or geographic areas to target interventions and guide analytic studies Develop a hypothesis that leads to analytic studies about risk factors for disease causation, propagation or progression

9. Levels of surveillance Individual surveillance: for all infected cases till they become non-infectious, highly fatal diseases Local population surveillance: malaria, sexual practices in a defined population National population surveillance: POLIO International Surveillance: conducted routinely by WHO Diseases under international surveillance

10. Types:

11. Active surveillance Highly contagious, fatal or in the process of elimination or eradication of disease Criteria established for reporting disease, risk factors or health event Regular outreach to potential reporters, to stimulate the reporting of specific diseases or injuries.

12. Active surveillance Means of validating the representative nature of passive reports and providing a more complete reporting of health events. Eg : Domiciliary fortnightly visits for malaria cases in NVBDCP Project Nikshay for active TB surveillance

13. Passive surveillance

14. Passive surveillance Criteria are established for reporting Health practitioners are notified of the requirements, and they report events as they come to their attention Not a huge burden to the reporter Vulnerable to incompleteness

15. Behavioural surveillance Ongoing systematic collection, analysis and interpretation of behavioural data relevant to understanding trends in the transmission of HIV and STIs. Knowledge Attitude Behaviour

16. Nutritional surveillance Tool for identifying existing system for collecting existing system for collecting information on the current and future magnitude, distribution and causes of malnutrition in populations In order to assist govt and international agencies in policy formulation, program planning, management and evaluation Eg : Short-term – excess intake of salt Long-term – less intake of fruits and vegetables HTN COLON CANCER

17. Increased salt intake

18. Sentinel surveillance Unlinked anonymous testing of persons for diseases under surveillance When we suspect missing cases or diseases of high-level social stigma

19. Surveillance in practice

20. Sources of data Mortality and morbidity reports Hospital records Laboratory diagnosis Outbreak reports Vaccine utilisation Sickness absence records Biological changes in agents, vectors and reservoirs Blood banks Any element of the causal chain of disease

21. Factors that influence the effectiveness of surveillance data Fewer no. Of conditions Little information per case Small burden of reporter High interest of decision-makers in surveillance data Clear and supported goals for surveillance Reporting strategy for serious but common conditions High usefulness of data locally High usefulness of data to decision-makers for prevention action

22. Surveillance in India In Maharashtra, the WHO has been supporting the use of geographical information system (GIS) in epidemiological surveillance in 13 districts The WHO software “Health Mapper” has been customized to suit the needs of Maharashtra and the staff of these 13 districts have been trained in its use. The WHO is supporting two operations research initiatives on the involvement of medical colleges and private practitioners in public health surveillance.

23. Integrated disease surveillance This is a decentralized, state-based surveillance programme, which was formally launched on 8 th November 2004. Major components of IDSP are -: Decentralizing surveillance activities. Strengthening public health laboratories. Using information technology optimally. Enhancing human resource development.

24. The IDSP amalgamates both public and private sectors by involving private participation and integrates surveillance of communicable and non - communicable diseases which includes -: Describing health problem Monitoring trends Estimating health burden Evaluating programmes for prevention and control

25. Disease under surveillance include- Malaria Acute diarrhoeal diseases Typhoid Tuberculosis Measles Polio Meningoencephalitis, respiratory distress, haemorrhagic fever and other undiagnosed conditions

26. Infections under sentinel surveillance (HIV, HBV and HCV) Water and outdoor air quality for large urban centres. Regular periodic surveys will be undertaken for risk factors of non- communicable diseases (anthropometry, physical activity , blood pressure, tobacco and diet) by outsourcing to an agency.

27. Monitoring Monitoring is the process of observing whether an activity or service is occurring as planned. It implies systematic and purposeful observation, aiming to identify any diversion from the planned course of action. It is a routine tracking of program using input, process, output and outcome data collected on a regular and ongoing basis. This helps identify the need for more formal evaluation of activities and find timely solutions to the problems.

28. Health management information system Web-based monitoring system developed by the Ministry of Health and Family Welfare under the National Health Mission. Its purpose is to monitor the performance of programs and services provided through the large network of health facilities across rural and urban areas by the use of information technology and provide timely feedback to improve the performance.

29. Training management information system DYNAMIC DATABASE Real-time training Registration Certificate generation Post-training evaluation Post-training deployment of NRHM staff Single window Two types of database STATIC DATABASE Training guidelines Training manuals Course content Circulars

30. References Basic Epidemiology, Bonita page no. 127, 129-130, IAPSM textbook of Community Medicine, page no 154, 303, 365, 793, 884, 529