The Integrated Disease Surveillance Project (IDSP) is a decentralized, state-based project that aims to establish a disease surveillance system for timely public health action. It integrates disease surveillance at state and district levels, improves laboratory support, and provides training. The IDSP oversees surveillance of diseases like malaria, diarrhea, tuberculosis, measles, and more. It has a strong organizational structure from the national to district levels to monitor diseases and respond to outbreaks. The IDSP reporting system utilizes forms to report suspect, probable and confirmed disease cases weekly from health centers to the state and national levels.
The National Family Welfare Programme was launched in 1952 in India to promote family planning and improve maternal and child health. It provides reproductive healthcare services, conducts immunization programs, and distributes medical supplies and equipment to primary healthcare centers. The objectives are to reduce population growth, improve access to family planning services, and lower infant and maternal mortality rates. Services include antenatal, natal, and postnatal care for mothers; immunizations for children; family planning methods; and emergency obstetric care. The program aims to improve quality of life through these comprehensive welfare services.
Pulse Polio is an immunisation campaign established by the government of India to eliminate poliomyelitis (polio) in India by vaccinating all children under the age of five years against the polio virus.
The document discusses India's National Urban Health Mission. The mission aims to provide equitable access to quality health care for the urban poor population as cities are seeing rapid growth. It focuses on improving the efficiency of the public health system and promoting partnerships between government and non-government providers. The mission seeks to meet the health needs of vulnerable groups like slum dwellers through primary health centers, community-based health insurance, and initiatives like the Urban Social Health Activist program. It was established to address the lack of standards and economic barriers to healthcare access faced by many in urban areas.
The National Leprosy Eradication Program (NLEP) in India aims to eliminate leprosy through early case detection and treatment. It provides free diagnosis and multi-drug therapy for leprosy patients. Major activities include case detection, disability prevention, awareness campaigns, and training of health workers. The global strategy for 2016-2020 aims for zero disabilities among new cases and less than 1 case of visible deformity per million people. New initiatives under NLEP include preventive treatment for contacts, a leprosy vaccine, a quarterly newsletter, GIS mapping of cases, and the SPARSH awareness campaign. The program focuses on eliminating leprosy nationwide through comprehensive care and community engagement.
The National Family Welfare Programme was launched in 1952 in India to promote family planning. It aims to improve quality of life through various components like administration, training, health education, and family planning services. The Reproductive and Child Health Programme was launched in 1997 to further the objectives of reducing infant and maternal mortality rates. It provides maternal and child healthcare services, family planning, and prevention of HIV/AIDS. The various methods of family planning discussed are natural methods, mechanical methods, hormonal methods, and surgical methods.
National health and family welfare programs in India aim to improve public health. There are many national health programs that focus on controlling communicable diseases, improving sanitation, and controlling population growth. These programs are implemented through intersectoral coordination between government agencies and non-governmental organizations. National health programs address issues like vector-borne diseases, malaria, filariasis, tuberculosis, HIV/AIDS, blindness, nutrition deficiencies, and more. Effectiveness of programs relies on factors such as improving service quality, resources, training, and generating public awareness. Non-governmental organizations also play important roles in supporting national health programs through activities like research, education, and community services.
The document discusses the history and ongoing efforts of the Pulse Polio immunization campaign in India. It was established in 1995-1996 to eliminate polio by vaccinating children under age 5. The campaign has faced difficulties including lack of infrastructure, funding and health services. Rumors have spread that the vaccines contain unsafe ingredients, but investigations found no evidence of this. The campaign aims to replace wild poliovirus and vaccinate all children under 5 through intensified immunization programs. Future benefits of eradicating polio globally include saving lives and funds that can be used for other health priorities.
Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004 for a period upto March 2010. The project was restructured and extended up to March 2012. The project continues in the 12th Plan with domestic budget as Integrated Disease Surveillance Programme under NHM for all States with Budgetary allocation of 640 Cr.
A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT head quarters and District Surveillance Units (DSU) at all Districts in the country have been established.
Objectives:
To strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs)
Programme Components:
Integration and decentralization of surveillance activities through establishment of surveillance units at Centre, State and District level.
Human Resource Development – Training of State Surveillance Officers, District Surveillance Officers, Rapid Response Team and other Medical and Paramedical staff on principles of disease surveillance.
Use of Information Communication Technology for collection, collation, compilation, analysis and dissemination of data.
Strengthening of public health laboratories.
The Revised National Tuberculosis Control Programme (RNTCP) was initiated in India in 1997 to address the limitations of the previous National Tuberculosis Control Programme. RNTCP follows the WHO recommended DOTS strategy and aims to decrease TB mortality and morbidity. It has a decentralized organizational structure and seeks to achieve at least 90% cure rates for new sputum-positive cases and detect at least 85% of expected new sputum-positive cases. RNTCP relies on sputum testing, DOTS treatment, and engagement with private providers and communities to control TB in India.
This document summarizes several national health programs in India, including: the National Vector Borne Diseases Control Programme, Revised National Tuberculosis Control Programme, National Leprosy Eradication Programme, National AIDS Control Programme, and others focused on malaria, filaria, Japanese encephalitis, chikungunya, dengue, blindness prevention, and reproductive and child health. It provides details on the objectives, strategies, and organization of implementation for many of these public health initiatives.
The document summarizes India's Universal Immunization Programme (UIP), which began in 1985 to provide several vaccines to infants, children, and pregnant women. The UIP aims to immunize against 12 vaccine-preventable diseases and has helped reduce child mortality by 75% in India. It also describes key vaccination initiatives under UIP like Mission Indradhanush, which was launched in 2014 to increase vaccination coverage for children under age 2, especially in rural areas. Intensified versions of Mission Indradhanush were later launched to boost immunization rates further.
Adverse Events Following Immunization (AEFIs)INAAMUL HAQ
This document discusses adverse events following immunization (AEFI). It defines AEFI as any untoward medical occurrence that follows immunization but does not necessarily have a causal relationship to the vaccine. AEFIs are classified based on whether they are related to the vaccine product, a vaccine quality defect, an immunization error, immunization anxiety, or are coincidental. Serious AEFIs that require reporting include death, hospitalization, disability, and life-threatening events. AEFI reporting and surveillance procedures in India involve using a case reporting form within 24-48 hours and a preliminary and final case investigation form within 10 and 70 days respectively.
The document outlines India's National Programme for Health Care of Elderly (NPHCE). Key points:
1) NPHCE aims to provide accessible and high-quality healthcare services to India's aging population through community-based primary care and establishing regional geriatric centers.
2) Services include health promotion, prevention, treatment and rehabilitation delivered at sub-centers, PHCs, CHCs, district hospitals and 8 regional geriatric centers.
3) The program strategy involves training healthcare workers, establishing geriatric infrastructure at various levels, and promoting convergence across departments serving elderly populations.
This document provides an overview of the AIDS Control Programme in India. It discusses the structure and goals of the National AIDS Control Programme (NACP), which aims to prevent further transmission of HIV and minimize socioeconomic impacts. The key components of NACP include targeted interventions for high-risk groups, expanding HIV testing and treatment nationwide, and scaling up prevention among the general population through strategies like promoting condom use and preventing parent-to-child transmission. NACP III (2007-2012) aimed to halt the HIV epidemic by increasing access to treatment while strengthening strategic information systems and capacity building.
The National AIDS Control Programme was launched in 1987 with the aims of preventing further HIV transmission, decreasing morbidity and mortality, and minimizing socio-economic impact. It established the National AIDS Control Organization to implement and monitor the programme. NACP-IV, launched in 2012, aims to halt and reverse the HIV epidemic over five years through prevention services targeting high-risk groups, treatment, care and support for people living with HIV/AIDS.
The document provides information about the Integrated Disease Surveillance Programme (IDSP) in India. It discusses that IDSP aims to establish a decentralized disease surveillance system to detect early warning signals of outbreaks. Key elements of IDSP include detection and reporting of health events, investigation and confirmation of cases, collection and analysis of surveillance data, and feedback to initiate public health responses. IDSP implementation is organized at the national, state, and district levels with defined roles and reporting structures. The program coordinates surveillance of both communicable and non-communicable diseases using standardized reporting forms.
Integrated Diseases Surveillance Project - IDSP IndiaRizwan S A
The document provides an overview of the Integrated Disease Surveillance Project (IDSP) in India. IDSP aims to establish a decentralized district-based system for surveillance of communicable and non-communicable diseases. Key aspects of IDSP include integrating existing disease surveillance, strengthening public health laboratories, using information technology, and developing human resources. IDSP implements syndromic, presumptive, and confirmed surveillance for various diseases. Information flows from the community level up through district, state, and national surveillance committees, which analyze data and coordinate response actions. New IDSP initiatives include an alert call center, e-learning modules, and a media scanning cell.
The Integrated Disease Surveillance Project (IDSP) was launched in 2004 with World Bank assistance to improve disease outbreak detection and response in India. It established a decentralized surveillance system from the national to district levels. Key components include syndromic surveillance, reporting of priority diseases, strengthening laboratories, and using information technology. However, integration with other health programs remains a challenge. Issues exist at the national, state, and district levels including staff shortages, lack of coordination, and underreporting that weaken disease surveillance. While IDSP established an important framework, ongoing efforts are needed for it to reach its full potential.
Surveillance involves the ongoing collection and analysis of disease data to inform prevention and control measures. In Nepal, disease surveillance occurs through both routine monthly HMIS reporting from all health facilities, as well as sentinel surveillance through the Early Warning and Response System (EWARRS) which collects weekly data from selected sites. EWARRS focuses on priority diseases like polio, measles, neonatal tetanus, malaria, kala azar, and Japanese encephalitis to allow for early detection and response to outbreaks. The data collected through these surveillance systems are used for monitoring disease trends, outbreak detection, evaluating health services, and informing public health policies and programs.
Integrated Disease Surveillance ProjectSandeep Das
The document describes India's Integrated Disease Surveillance Project (IDSP), which aims to establish a decentralized, district-based system for surveillance of communicable and non-communicable diseases. Key elements of IDSP include integrating existing surveillance activities, strengthening public health laboratories, using information technology, and developing human resources for surveillance and response at the district, state, and national levels. IDSP collects surveillance data on various diseases through syndromic, presumptive, and confirmed case reporting. Data flows from the district to state and national levels to allow for analysis and coordinated response.
Public health surveillance involves the ongoing collection and analysis of health data to support public health programs and policies. It is used to monitor disease outbreaks and other health issues. India has implemented an Integrated Health Information Platform (IHIP) to create a single system for collecting and analyzing real-time surveillance data from across the country. IHIP aims to improve disease monitoring and response by integrating data on over 33 health conditions from various programs into one electronic platform. It allows identification of outbreaks and resource allocation through features like automated epidemic curve analysis and geospatial mapping of disease clusters. While IHIP has integrated some vertical programs, full integration remains a work in progress. Limitations also include challenges in implementation, private sector involvement, and
The Integrated Disease Surveillance Project (IDSP) aims to establish a decentralized disease surveillance system in India to improve disease control. It integrates existing surveillance programs, coordinates surveillance activities, and establishes quality data collection, analysis, and feedback using information technology. The IDSP covers diseases like malaria, acute diarrheal diseases, tuberculosis, and measles. It is implemented in phases across states and union territories of India and involves strengthening laboratories, training health professionals, and creating an IT network to link surveillance sites. The goal is to provide data to enable efficient public health decision making and interventions for priority diseases.
Surveillance and monitoring are important public health activities. Surveillance involves the ongoing collection and analysis of health data to plan, implement, and evaluate public health programs. It can be used to monitor disease trends, assess prevention programs, and recognize disease outbreaks. There are different levels of surveillance from individual to international. Types include active, passive, sentinel, behavioral, and nutritional surveillance. India has integrated disease surveillance programs to monitor communicable and non-communicable diseases across public and private sectors. Monitoring tracks program implementation and identifies solutions to improve performance using routine data collection. The health management information system is a web-based tool used in India to monitor health services and programs.
1. The Integrated Disease Surveillance Project (IDSP) was launched in 2004 to establish a decentralized disease surveillance system in India to enable timely public health responses.
2. IDSP aims to integrate disease surveillance activities across national health programs, private sector organizations, and state governments.
3. The project works to detect disease outbreaks early through establishing surveillance units at central, state, and district levels that monitor for priority infectious diseases and public health events.
Public health surveillance involves the continuous collection and analysis of health data to support public health practices. It can be used for immediate detection of epidemics or long-term monitoring of disease trends. Active surveillance employs staff to directly collect data while passive surveillance relies on voluntary reporting from healthcare providers. Syndromic surveillance monitors clinical symptoms before confirmation of diagnoses. Integrated disease surveillance at national and global levels aims to strengthen communicable disease monitoring through standardized guidelines and collaboration across networks.
Integrated Disease Surveillance Programme (IDSP).pptxMostaque Ahmed
The Integrated Disease Surveillance Programme (IDSP) aims to establish a decentralized district-based system for surveillance of communicable and non-communicable diseases in India. It was launched in 2004 to integrate existing disease surveillance activities across programs to avoid duplication and facilitate information sharing. The objectives are to initiate timely public health responses to disease changes at urban and rural levels. Key elements include detection, investigation, data collection, analysis, interpretation and feedback. The IDSP decentralizes surveillance to the state and district levels and strengthens human resources, public health laboratories, and inter-sectoral coordination.
Sources of health information in India.pptxMostaque Ahmed
1) Health information systems in India utilize various data sources including census data, vital statistics, sample registration systems, disease notification, hospital and health center records, surveys, and environmental records.
2) The sources are used to measure population health status, assess health programs and service delivery, conduct research, and inform health planning and policy decisions.
3) Key sources include the decennial national census, civil registration of vital events, sample registration system which provides annual health and demographic data, and population-based national health surveys.
The key objective of the programme is to strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs).
The document discusses public health surveillance, providing definitions and outlining its goals, history, uses, types, attributes, and process. It describes key public health surveillance programs in India, including the Integrated Disease Surveillance Program (IDSP) and National Surveillance Programme for Communicable Diseases (NSPCD). The goal of public health surveillance is to provide information to guide public health policies and programs by ongoing collection and analysis of health data. Effective surveillance systems aim to detect health issues, monitor trends, and link data to appropriate public health actions and interventions.
This document discusses surveillance of risk factors for non-communicable diseases (NCDs) in India. It describes the need for NCD risk factor surveillance given the increasing burden of NCDs. Surveillance of risk factors like tobacco use, alcohol consumption, obesity, diet, physical activity and blood glucose/cholesterol levels is recommended through periodic sample surveys. The role of district surveillance officers includes organizing such surveys involving collection of demographic, behavioral and biological data on NCD risk factors from the community. Ensuring valid and reliable surveillance methods is important to generate accurate data on trends and patterns of NCD risk factors.
Surveillance for Public Health Issues in Specific Situation.pptxAtoillahIsvandiary
Public health surveillance is used to monitor population health status, measure needs for interventions, and assess effects of interventions. The document discusses different types of surveillance including active, passive, categorical, integrated, and syndromic surveillance. It also discusses using surveillance to monitor specific public health issues like environmental health, injuries, bioterrorism, disasters, refugees, and chronic diseases. The key is collecting, analyzing, and disseminating timely, useful data to inform public health decision-making.
RMNCH+A strategy: Reproductive, Maternal, neonatal, child and Adolescent Health Gaurav Kamboj
This document provides an overview of the RMNCH+A strategy in India. It discusses the historical background and goals of reducing maternal and child mortality. The key challenges include operating the different components vertically and strengthening adolescent health. Major causes of maternal and child deaths in India are hemorrhage, sepsis, abortion for mothers and pneumonia, preterm birth and sepsis for under-5 children. The strategy aims to address these across various life stages through interventions like adolescent nutrition programs, skilled birth attendance, emergency obstetric care, and postnatal care for mothers and newborns. It also discusses strengthening the health system to deliver comprehensive RMNCH+A services and monitoring progress.
Middle East Respiratory Syndrome: MERS- CoVGaurav Kamboj
This document provides an overview of Middle East Respiratory Syndrome (MERS) including: the causative coronavirus; epidemiology and current status of MERS cases globally and in South Korea; the dromedary camel as the suspected animal reservoir; modes of transmission between camels and humans and between humans; clinical presentation and course of illness; laboratory diagnosis; treatment and prevention recommendations; and traveler guidelines. MERS is a viral respiratory illness first reported in 2012 with a case fatality rate of 36% that has caused several outbreaks, primarily in the Middle East.
Randomized controlled trial: Going for the GoldGaurav Kamboj
Dr. Gaurav Kamboj's document discusses the hierarchy of evidence and research designs. It provides background on the history of randomization in research from its first use in 1747 to establish the gold standard of randomized controlled trials (RCTs). The document describes the basic design of RCTs and different types of RCT study designs including parallel, crossover, factorial, and cluster designs. It outlines the basic steps to conduct an RCT including developing a protocol, selecting study populations, random allocation of subjects, intervention/manipulation, follow-up, and outcome assessment.
This document discusses logistic regression, including:
- Logistic regression can be used when the dependent variable is binary and predicts the probability of an event occurring.
- The logistic regression equation calculates the log odds of an event occurring based on independent variables.
- Logistic regression is commonly used in medical research when variables are a mix of categorical and continuous.
Meta analysis: Made Easy with Example from RevManGaurav Kamboj
This document provides an overview of meta-analysis, including:
1) Meta-analysis allows researchers to quantitatively combine the results of multiple studies on a topic to arrive at overall conclusions about the body of research.
2) The key steps of conducting a meta-analysis include developing a research protocol, performing a comprehensive literature search, selecting studies, assessing study quality, extracting data, analyzing data, and addressing heterogeneity and publication bias.
3) Funnel plots and statistical tests can be used to examine potential biases like publication bias in a meta-analysis. Addressing these biases helps ensure the meta-analysis provides an accurate summary of the evidence.
In the healthcare field, precise and comprehensive documentation is essential for delivering high-quality patient care. One of the most critical components of clinical documentation is the SOAP note. At GPAShark.com, we specialize in providing expert SOAP note writing services, tailored to meet the needs of nursing students, healthcare professionals, and medical practitioners. Our goal is to help you master the art of SOAP note writing, ensuring your documentation is thorough, accurate, and effective.
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SOAP stands for Subjective, Objective, Assessment, and Plan. This structured method of documentation is used widely in healthcare settings to ensure consistent and clear communication among healthcare providers. Each component of a SOAP note serves a specific purpose:
Subjective (S):
This section captures the patient's narrative, including their chief complaint, history of present illness (HPI), past medical history (PMH), family history (FH), social history (SH), and review of systems (ROS). It reflects the patient's perspective and is crucial for understanding their condition and concerns.
Objective (O):
The objective section includes measurable and observable data collected during the physical examination and diagnostic tests. This might involve vital signs, laboratory results, imaging studies, and physical exam findings. Objectivity is key to providing a factual basis for the assessment.
Assessment (A):
In the assessment section, the healthcare provider synthesizes the subjective and objective data to formulate a diagnosis or differential diagnoses. This analysis helps in understanding the patient's condition and guiding the treatment plan.
Plan (P):
The plan outlines the course of action, including treatment strategies, medications, diagnostic tests, patient education, and follow-up appointments. It provides a roadmap for managing the patient's condition and achieving desired health outcomes.
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2. Outline of Presentation
• What is Surveillance?
• Need for IDSP
• Introduction to IDSP
• Objectives
• Diseases and Conditions under IDSP
• Organisational structure
• Formats and Reporting
• Case definitions and Trigger events
• Information flow and linkages
• Newer Initiatives
• Performance indicators
• Conclusion- Critical Review
3. Surveillance in its simplest form is collection of
information for action.
Disease Surveillance is a systematic process of
reporting of various diseases of public health
importance, as & when & where they occur, to a
designated agency responsible for taking effective
interventional steps.
Its success depends on 3Rs:
Recognition- quality of diagnosis, case definitions
Reporting- timely and complete
Response- analysis and effective feedback
What is Public Health
Surveillance ?
4. Need For IDSP?
• Because data was being COLLECTED SEPARATELY AND
USED SEPARATELY by the various program managers
• Data was never used comprehensively at national level
• Huge resources were being used separately and sometimes
DUPLICATION OF FUNDS also occurred
• The epidemiological impact of the outbreak control
measures can be expected to be significant only if these
measures are APPLIED IN TIME.
5. Importance of timely action in controlling an
outbreak through effective surveillance action
6. National Surveillance Programme
for Communicable Diseases
(NSPCD)
• Launched in 1997-98 in five pilot districts of the country
• Extended to cover 101 Districts in all 35 states and UTs
in the country
• States were the implementing agencies and NICD(now
NCDC) Delhi was the Nodal agency
• Based on outbreak reporting (as and when outbreaks
occur) with weekly reporting of epidemic prone diseases
directly from Districts (including nil reporting) to the
Centre.
7. IDSP- Introduction
• IDSP is a decentralized, state based surveillance
programme in the country
• GoI in Nov 2004 ; totally funded by World Bank
• Launched 3 Phases
• Haryana- Launched on 1.4.2005 (2nd phase)
• Extended for 2 years in March 2010- WB funded only for 9
states & CSU, Rest funded by Domestic budget
• Continued during 12th Plan under NRHM with total
domestic funding of Rs. 640.40 Crore
8. Phasing of Integrated Disease Surveillance Project
Phase II (05-06)
Phase-I (04-05)
Phase III (06-07)
9. Objectives
• To establish a decentralized State based system for
communicable diseases to detect the EARLY WARNING
SIGNALS, so that the timely and effective public health
actions can be initiated
• To improve the efficiency of disease control programs &
facilitate sharing of relevant information with various
stakeholders so as to detect disease trends over time &
evaluate control strategies
10. Integration
• All National Disease Control Programmes
• Health & Non Health sectors (Police, PCBs, Water supply)
• Including NCD & CD
• Laboratory information
• Private sector & NGOs
• Academic Institution & Medical Colleges
• IEC activities
• Training
No
allaince
13 Pvt Practitioners + 10 Pvt Labs
Monthly meeting with IMA, NIMA
Red cross society, Senior citizen
association, Rotary club
11. Disease And Conditions Covered
Under IDSP
The disease to be included in the surveillance
program will be based on the following criteria:
• Does the disease condition have high health impact?
(morbidity, mortality, disability) {Malaria, NCD risk
factors, Road Traffic Accidents (RTA)}.
• Does it have significant epidemic potential?
(Cholera, Measles).
• Is it a target of a specific national, regional or
international disease control programme? (HIV, TB,
Polio).
• Will the information collected lead to significant
public health action?
12. Type of disease Disease
Vector borne diseases Malaria
Water borne diseases Diarrhoea, Cholera, Typhoid, Jaundice
Respiratory diseases Tuberculosis, ARI
Vaccine preventable diseases Measles
Disease under eradication Polio
Other conditions Road traffic accidents
International commitment Plague, Yellow fever
Unusual syndromes
(Causing death/hospitalization)
Meningoencephalitis/ Respiratory distress
Hemorrhagic fever
Other undiagnosed condition
Disease And Conditions Covered
Under IDSP
13. Other conditions under
surveillance
Type of surveillance Categories Conditions
Sentinel surveillance STDs HIV/HBV/HCV
Other conditions Water quality
Outdoor air quality
Regular periodic surveys
Non-communicable
disease risk factors
(ICMR)
Anthropometry
Physical activity
Blood pressure
Tobacco
Nutrition
Blindness
Additional state priorities Up to five diseases
14. State Specific Diseases for Haryana
Meningococcal Meningitis
Dengue
Viral Hepatitis
J.E
16. Project components & Highlights
• Limited number of conditions based on state perceptions
(13core, 5 state priority conditions) for which pubic health
response is available.
• CSU integrated with National Center for Disease Control (NCDC)
• SSU & DSU in all states & districts
• Strengthening Public Health Laboratories (microbiologist, grant of
2 lakh/yr)
• Training of SSU/DSU/RRT (over in all states & UT)
• IT & Networking & Human Resource Development
• IDSP Portal and Self learning e-module- 2weeks course
17. Organizational Structure
National Surveillance Committee
Central Surveillance Unit
State Surveillance Committee
State Surveillance Unit
District Surveillance Committee
District Surveillance Unit
18. Chairperson*
National surveillance
committee
Director General
Health Services
(Co. Chair)
Director General
ICMR
PD
(IDSP)
JS
(Family Welfare)
Director
NICD
Director
NIB
National Program Managers
Polio, Malaria, TB, HIV - AIDS
Consultants
(IndiaCLEN / WHO
/ Medical College
/others)
NGO
IMA
Representative
Representative
Ministry of Home
Representative
Ministry of Environment National Surveillance Officer
(Member Secretary)
* Secretary health and secretary family welfare
National surveillance committee
The committee will be responsible for major policy decisions in:
implementing IDSP,
coordination with other ministries, departments and organizations
and review progress in implementation of IDSP.
19. Central Surveillance Unit
• NCDC, Delhi.
• National Project Officer(NCDC): Dr. Jagvir Singh,
Additional Director
• Executes the approved annual plan of action for IDSP and
monitor progress in states.
• Conduct central level training and review meetings with
SSOs.
• Analyze data received from states and provide feed back
on trends observed.
• Form and supervise the movement of RAPID RESPONSE
TEAM at the central level to supplement efforts of states
during disaster or epidemics of a very large magnitude
20. Chairperson*
State surveillance committee
Director Health Service
Director Public
Health (Co. Chair) Director Medical Education
Representative
Water Board
NGO
Medical Colleges
State Coordinator
Representative
Department of Home
State Program Managers
Polio, Malaria, TB, HIV - AIDS
Head, State Public
Health Lab
IMA
RepresentativeRepresentative
Department of Environment State Surveillance Officer
(Member Secretary)
State Training Officer
State Data Manager IDSP
State surveillance committee
* State health secretary
21. State Surveillance Unit
1. State Surveillance Officer (Joint Director)
2. Rapid Response Team Representatives
3. Consultant (Training & Technical)
4. Consultant (Procurement & Finance)
5. Data Manager
6. Data Entry Operators
This unit will be responsible for :
The collation and analysis of all data being received
from the districts and transmitting the same to the
Central Surveillance Unit.
22. SSU- Haryana
• Director (SSO) - Dr. Kamla Singh
• Deputy Director - Dr. Aparajita Sondh (08288021859)
• State Nodal Officer - Dr. Jyoti Kaushal (09876500239)
• St. Consultant Training - Dr. Ravinder Singh (09463912215)
• State Epidemiologist - Ms. Neha Narula (09872810014)
• State Microbiologist - Mr. Sombir (09815195544)
• Data manager - Mr. Sandeep Thakur (09501971141)
Reporting Units- 3231 (Public – 3108, Pvt – 123)
23. District Surveillance Committee
Chairperson*
District Surveillance Committee
District Surveillance Officer
(Member Secretary)
CMO
(Co. Chair)
Representative
Water Board
Superintendent
Of Police
IMA
Representative
NGO
Representative
District Panchayat
Chairperson
Chief District PH
Laboratory
Medical College
Representative
if any
Representative
Pollution Board
District Training Officer
(IDSP)
District Data Manager
(IDSP)
District Program Manager
Polio, Malaria, TB, HIV - AIDS
* District Collector or District Magistrate
25. DSU- Rohtak
• Located at Civil Surgeon’s Office, Rohtak
• Distt Surveillance Officer - Dr. Ved Pal
• Epidemiologist - Dr Vivek Mor
• Data manager - Vacant
• Data operator - Smt. Rekha
Reports from all reporting units (Public- 189, Pvt- 23) is
received by Tuesday,
Compiled and send SSU till Wednesday and
Entered into IDSP portal by Thursday
29. IDSP Committee – PGIMS Rohtak
• Chairperson - Dr. Ashok Chauhan (M.S.)
• Co-ordinator - Dr. R.B. Jain (Prof, Comm.
Med.)
• Members
– Dr. Pardeep Khanna (Sr. Prof. and HOD, Comm. Med.)
– Dr. J.S. Malik (Sr. Prof. and Head-II, Comm. Med.)
– Head Microbiology, Medicine, Paeds, Gynae, T.B.
Chest
• Meet once in 3 months
• Last meeting was about 5 months back
30. Formats And Reporting
S – FORM (Syndromic)
P – FORM (Presumptive)
L – FORM (Laboratory)
REPORTING SYSTEM –WEEKLY REPORTING (Mon- Sun)
DAILY REPORTING IN CASE OUTBREAK HAS BEEN IDENTIFIED
34. Form Level of Laboratory Responsibility of
Reporting
Form L1 Peripheral Laboratory at
PHC/CHC
Laboratory Assistants/
Technician through
MO I/C
Form L2 District Public Health Lab,
Labs of District Hospital,
Private and other Hospitals &
Private Labs.
I/c Microbiologist/
Pathologists
Form L3 Labs in Medical Colleges, other
tertiary institutions, state
reference labs
Reference Labs.
Head, Microbiologist
Department
Laboratory Reporting
35. In the year 2008-09, two Districts priority labs
i.e. Hisar & Panchkula and One State Lab i.e.
Karnal have been upgraded
Haryana
40. Types of case definitions in use
Case definition Criteria used Who does it
Syndromic Clinical pattern Paramedical personnel and
members of community
Presumptive Typical history and
clinical examination
Medical officers of
PHC/CHC
Confirmed Clinical diagnosis by a
medical officer and
positive laboratory
identification
Medical officer and
Laboratory staff
55. Methods Of Data Collection
• Universal
– Routine reporting ( institutional based or passive
reporting)
• Need and area specific:
– Sentinel surveillance
– Active surveillance (active search for cases)
– Vector surveillance
– Laboratory surveillance
– Sample surveys
– Outbreak investigations
56. S
Programme Officers
D.S.U.
S.S.U.
C.S.U.
INFORMATION FLOW
WEEKLY SURVEILLANCE SYSTEM
Other Hospitals:
ESI, Municipal
Rly., Army etc
Sub-Centres
P.H.C.s
C.H.C.s
Dist. Hosp.
Med. Col.
P.H. Lab
Pvt. Practitioners
Nursing Homes
Private Hospitals
Private Labs
Corporate
Hospitals
IDSP Portal : The IDSP portal is one stop portal
which has facilities for data entry, view reports,
outbreak reporting data, analysis, training modules
and resources related to disease surveillance.
All district are connected
through Broad Band
PGIMS Rohtak
MAMC, Agroha
57. • Reports consolidated from various deptt:
•Medicine, Gynae-Obs, Pediatrics, TB chest, Skin & VD
• Validity of reports is doubtful seeing such a low no. of
cases being reported
• Reports of ONLY indoor cases is sent
• No OPD reporting of presumptive cases from institution
• Over-worked staff, Multi-tasking
•No in-built mechanism of reporting
58. Linkages at Central level
Outbreak Investigation
& Rapid Response
NCD Surveillance MIS & Report
Programme Monitoring
NVBDCP RNTCP RCH
NACO
W.H.O. E.M.R.
CSU
NCDC
National
Programs
CBHI
ICMR
EMR-Emergency
Medical Relief
CBHI-Central Bureau of
Health Intelligence
59. Level of response
• Specified in the form of trigger:
Trigger-1 -- Local response by health worker, M.O.
Trigger-2 -- District level response by DSO, RRT
Trigger-3 -- State level response to an established
outbreak
Trigger-4 -- National level response
Trigger-5 -- International level response to an
established outbreak.
60. Warning signs of an impending
outbreak
1. Clustering of cases or death in time and/ or space
2. Unusual increase in cases or death
3. Even a single case of measles, AFP, cholera, plague,
dengue or JE
4. Acute febrile illness of unknown etiology
5. Occurrence of two or more epidemiologically linked
cases of meningitis, measles
6. Unusual isolate
7. Shifting in age distribution of cases
8. High vector density
9. Natural disasters.
62. Last outbreak in Distt. Rohtak
Diarrhoea in Vill. Gilohar Kalan in
2013
Cause- Unavailability of Potable
drinking water
63. Outbreaks
Majority of the reported outbreaks were of Acute Diarrhoeal
diseases, Food Poisoning, Measles etc.
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2008 2009 2010 2011 2012 2013
553
799
990
1675
1584
1964
No.ofoutbreaks
Year
67. Training Centre Equipments
• ISRO has installed 330 out of 400 EDUSAT sites (6 in
Haryana)
• E-Learning Portal ( http://e-learning.nic.in/Ims ), 2
weeks course, which has facility in managing virtual life
classrooms for training (state/area specific discussion on
disease surveillance activities), e-learning and interactive
electronic discussion (chat rooms, boards, mailing lists)
Information And Communication
Network
Installed in PGIMS, Rohtak with Dr. Dhruv Chaudhary
Not used at all
Don’t know how to operate
69. New Initiatives
1. Alerts through IDSP call center
Call Centre operational with 1075 (1800-11-4377)
toll free number since February 2008
2,77,395 lakhs calls have been received from
beginning till 30th June, 2012
2. Community Based Surveillance
Active involvement of community institutions and
volunteers such as the PRI, VHSC, Mahila Mandals,
Self Help Groups(SHG), Youth Clubs, School, NGOs,
Traditional/ Private Health Care Providers
Pilot project in 3 states viz., Maharashtra, Orissa and
Karnataka.
70. 3. Media Scanning And
Verification Cell
• Established in July 2008 at NCDC, Delhi.
• Objective: To provide the supplemental information about
outbreaks
• Method: National & local newspapers, Internet, TV channel
screening for news items on disease occurrence.
• Benefits of Media Scanning:
– Increases the sensitivity & strengthen the surveillance system
– Provide early warning of occurrence of clusters of diseases
• 8-12 media alerts are being detected and verified per week.
• A total of 2537 health alerts have been detected till
November 2013 since its establishment.
71. 4. Entomology Unit
• Established in December 2008
• Vector borne epidemic prone diseases (VBD) like Malaria,
JE, Dengue, Chikungunya, Kala-azar, and Plague are of
major public health concern.
• Other diseases like KFD, tick typhus and other tick and mite
borne diseases are being reported in the areas where they
were not reported earlier.
• Objectives-
– Regular dissemination of data
– Technical support
– Entomological surveillance
– Monitor and evaluate the timeliness and quality of IRS, ITN
and distribution of larvivorous fishes.
72. Performance Indicators
• Number & % of districts providing monthly surveillance
reports on time – by state and overall *
• Number & % of responses to disease specific triggers on
time *
• Number of districts : private sector contribution C/H/L
• Number and % of districts & states publishing annual
surveillance reports
• Publication by CSU of consolidated annual surveillance
report
# assessed to be adequate *
75. Human Resource in Haryana
S.No. Position No.
Sanctioned
No. Working
1. State Surveillance Officer 1 1
2. State Nodal Officer 1 1
3. DSO 20 20
4. Data Manager 21 16
5. Data Entry Operators 21 19
6. Epidemiologist 21 18
7. Microbiologist 3 2
8. Entomologist 1 0
9. RRTs Working in all districts
77. Strengths of IDSP
• IDSP has clear cut ownership by the Govt. with the
National Cell located in the Union Ministry of
Health and Family Welfare
• Functional integration of surveillance components
of vertical programmes
• Reporting of suspect, probable and confirmed
cases (Standard case Definition and Trigger levels
for graded response)
• Strong IT component for data analysis
78. • Standard Formats, Operations & Training Manuals
• Compilation of disease outbreaks/alerts is done on
weekly basis and the weekly outbreak report
generated by the CSU is shared with all key
stakeholders every week including the Prime
Minister’s Office.
• Involvement of Private Sector- yields a better
assessment of disease trends as major part of the
population is dependent on them
Strengths of IDSP
79. National Issues
• Media attention an important consideration for
response
• ‘Overworked’ clinicians so poor records, heavy
workload in the periphery causing a gap in the
validity of data.
• Poor routine flow of funds
• Integration with Medical colleges is poor due to
the jurisdiction differences between Directorate
of Health and Directorate of Medical Education.
• Multiple formats for different programmes
80. State issues
• State RRT not utilized to full potential
• Regional labs strengthened but diagnosis is not
enhanced & increasing dependence on Centre thus
causing delay in response.
• Transfer/retirements of trained staff
• Shortage of staff so multi-tasking for state and
district
• Lack of competent staff : Epidemiologist &
Microbiologists, Short trainings incapable
81. District issues
• Surveillance is done by existing personnel after
training in specific modules- reduces cost of service.
• But its disadvantage is that data collected is only from
institutions (Sub-centres, PHCs, CHCs, District
Hospitals and Tertiary care centres) and not from field
surveys
• This data does not include cases who do not seek
health care thus indicating its limitations regarding
quality.
• District level reporting is not up to the mark due to
lack of infrastructure, communication failure and lack
of commitment.
82. • Surveillance failure : media reports first
• Weekly reports incomplete, irregular (UNDER
REPORTING)
• Monthly reports also irregular
• Peripheral and district labs are still not well equipped
• Disease Surveillance Laboratories generate hazardous
waste if not managed properly, carries the risk of
infection for waste handlers and to the larger
community
• RRT has specialists from DH & MC so problem in rapid
mobilization
District issues
83. • All activities being undertaken presently under
IDSP are proposed to continue by NCDC under
NRHM in the 12th Five-Year Plan with
objectives:
– To strengthen/maintain a decentralized laboratory
based IT-enabled disease surveillance system for
epidemic prone diseases to monitor disease trends
and to detect and respond to outbreaks in early
rising phase through trained RRTs.
– To establish a functional mechanism for inter-
sectoral co-ordination to tackle the zoonotic
diseases
Proposal for 2012-2017
84. • Given the huge area and population in India, effective
surveillance of diseases faces many challenges and a
lot of improvement is required to reach an optimal
level of surveillance.
• As IDSP has been implemented in stages with a small
set of priorities with a decentralized approach,
incorporating equal involvement of peripheral health
care centres and laboratories, targeting cumulative
data rather than individual data of cases, success can
be achieved with passage of time.
CONCLUSION
85. References
• J.Kishore’s National Health Programmes of India 10th
Edition . century publications
• Park’s Textbook of Preventive and Social Medicine , K.
Park 22nd Edition . Bhanot Publishers
• Health Policies and Programmes in India , Dr. D. K.
Taneja . 11th Edition . Doctors Publications
• Integrated Disease Surveillance Project: Operational
Manual For District Surveillance Unit
• IDSP website http://idsp.nic.in
• NCDC website http://ncdc.in
• IDSP Haryana website
http://haryanahealth.nic.in/menudesc.aspx?page=69