Weekly Assignment 2

Step 1. Select a country for this assignment.

 

India

 

Step 2. Join the WhatsApp group for this country.

 

Joined the country specific whatsapp group successfully

Step 3. Identify the questions you want to answer about data flow, data tools, and the performance of your country’s monitoring system

List and prioritize 2-5 questions that you want to answer toward the improvement of data for decision-making. These questions may include: ( 3 Questions answered )



▪How does data flow

 

Here am describing about the IDSP surveillance ( Integrated Disease Surveillance Program) data of India

The data flow is from village level (Sub Health centers ) to the Primary Health centers , community Health centers , District, state ( Province) and finally to National level ( Government of India)

 

 

Sub Health Centers( 2-4 villages) – 5000 to 6000 population

Primary Health centers (30,000 poulation)

Community Health center ( 1,00,000 poulation)

Sub district – Block level)

State (Province)

Country – (GOI) INDIA

District level

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

▪What are the different reporting layers (that is, who reports to whom) and what are the requirements for timeliness and reporting frequencies?

 

The sub centers are sending the data as per syndromic surveillance - S Form ( Syndromic Surveillance)
The Primary Health Centers, Community Health centers and Private Practitioners are sending the data as per Provisional diagnosis or Probable diagnosis - P Form ( from the OPD and Impatient Registers of the doctors)
Lab confirmed cases reports are collected from labs in Government Health System and Private Labs – L Form

 

– Subcenter level weekly reporting on every Saturday

Primary Health Centers and Community Health Centers are sending the weekly reports on Mondays after compilation
Districts are sending the Reports to state on every Tuesdays
States are sending the reports to GOI on every Wednesdays

 

▪Who first collects the data, prepares paper reports, enters data into electronic systems, receives and reviews reports?

 

Community Health Center collects the data from SHC and PHCs in Reporting formats ( Paper Reports) at Block level and then do the data entry in electronic system then compiling the Block data and send to Districts on all Mondays

At District level, all block reports got compiled and sent to State electronically on Tuesdays

States compile all district data and send to GOI on Wednesdays

 

 

▪What measures and procedures are in place for data verification, cleaning and feedback? What process is followed if data seems to be wrong?

▪Who are relevant players/stakeholders at each level? What do they do with the data (for example, collect, enter into electronic system, analyze, use to make decisions, etc.)?

 

 

 

Step 4. Identify and collect relevant background documents and other sources of information for your selected country.

You may want to start with what you already know (usually from experience) or what you can learn from your colleagues. However, in order to build a compelling analysis, you need to rely on evidence that is not only anecdotal.

 

India

 

Mission statement oF IDSP

To strengthen the disease surveillance in the country by establishing a decentralized State based surveillance system for epidemic prone diseases to detect the early warning signals, so that timely and effective public health actions can be initiated in response to health challenges in the country at the Districts, State and National level.

OBJECTIVES

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.

Information Communication Technology - for collection, collation, compilation, analysis and dissemination of data.

Strengthening of public health laboratories.

 

Potentially useful sources of information include:

 

1). https://idsp.nic.in/showfile.php?lid=4134

 

2). https://idsp.nic.in/showfile.php?lid=3947

 

▪country documentation on surveillance standards (including case definitions);

Standard operating procedures (SOPs)for data collection , archiving and reporting

Data collection stools and Annual Reports

https://idsp.nic.in/showfile.php?lid=3924

https://idsp.nic.in/showfile.php?lid=3923

 

▪paper-based tools and information systems for data entry, management, and analysis

▪country documentation or SOPs on data tools (paper or electronic) including SOPs on responsibilities and financing of printing the monitoring tools

https://idsp.nic.in/showfile.php?lid=3759

 

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.
Under the project weekly disease surveillance data on epidemic prone disease are being collected from reporting units such as sub centres, primary health centres, community health centres, hospitals including government and private sector hospitals and medical colleges. The data are being collected on ‘S’ syndromic; ‘P’ probable; & ‘L’ laboratory formats using standard case definitions. Presently, more than 90% districts report such weekly data through e-mail/portal (www.idsp.nic.in). 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.
States/districts have been asked to notify the outbreaks immediately to the system. On an average, 30-40 outbreaks are reported every week by the States. 553 outbreaks were reported and responded to by states in 2008, 799 outbreaks in 2009, 990 in 2010, 1675 outbreaks in 2011, 1584 outbreaks in 2012, 1964 outbreaks in 2013, 1562 outbreaks in 2014 and 311 outbreaks have been reported till 15th March 2015.
Media scanning and verification cell was established under IDSP in July 2008. It detects and shares media alerts with the concerned states/districts for verification and response. A total of 3063 media alerts were reported from July 2008 to November 2014 and 122 till 31st March 2015. Majority of alerts were related to diarrhoeal diseases, food poisoning and vector borne diseases.
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 centre 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.
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. Till date 29 States (65 labs) have completed the procurement. In addition, a network of 12 laboratories has been developed for Influenza surveillance in the country.
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.

 

Considering the non-availability of health professionals in the field of Epidemiology, microbiology and Entomology at district and state levels, MOHFW approved the recruitment of trained professionals under NHM in order to strengthen the disease surveillance and response system by placing one Epidemiologist each at state/district head quarters, one Microbiologist and Entomologist each at the state head quarters. The post of a Veterinary Consultant at State Surveillance Unit has been approved by the MOHFW recognizing the Mission Statement of One Health Initiative. 408 Epidemiologists, 181 Microbiologists, 25 Entomologists and 3 Veterinary Consultants are in position as on 31st March 2015.

 

▪organigram of the EPI team, HMIS team, and if available, post description of data managers or other staff dealing with monitoring, systems, and analysis

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. Con (Vet) added in 2013-14

District Surveillance Unit (DSU): One in each district with a regular officer as District Surveillance Officer (DSO). Supported by 3 contractual staff

 

▪other available documentation related to immunization data: country bulletins, peer-reviewed literature, ad hoc reports, and other descriptions of the information system.

 

 

 

Step 5. Share the most useful resources you find in our Scholar community SHARES.



https://idsp.nic.in/index.php

https://idsp.nic.in/showfile.php?lid=3924

https://idsp.nic.in/showfile.php?lid=3923

 

 

The Country name should be included in the title

INDIA

 

Each share must include a description , Summarize why you are sharing this document and how is it useful

 

In the “Credit” section, cite the source (organization and/or authors) if you know.

 

You may also choose to share the most useful documents you find with members of your country WhatsApp group.

 

 

Step 6. Perform a rapid review of these sources and evidence for data flow, tools, and performance of your country’s monitoring system.

Limit your review to find:

1. reliable sources (if they exist) that describe the data flow and data tools used in your country’s monitoring system; and

2. evidence that will help you identify strengths and gaps (through SWOT analysis) of the performance of your country’s monitoring system.

 

 

 

GAP ANALYSIS FORMAT

 

https://idsp.nic.in/showfile.php?lid=4020

 

 

Step 7. Summarize the quality of the available evidence.

Summarize the quality and completeness of your findings. If you rely on personal experience or the experience of colleagues, please state this explicitly. Consider these questions: Were you able to answer the questions you listed? It is acceptable for your review to be incomplete. What is the strength or level of evidence for what you have found? Can you identify gaps in the sources you reviewed? If your findings are incomplete, what else would you need to know to build a more comprehensive picture?

Step 8. Describe the data flow of your country.

Map out the data flow of your context, drawing on your findings.

Prepare a flow chart showing data flows and data tools being used across all levels.

Step 9. Make a SWOT analysis.

Make a SWOT analysis for the monitoring system in your country.

Analyze the Strengths, Weaknesses, Opportunities, and Threats.

STRENGTHS

Surveillance at all level and multilayered surveillance

Can pick up any health event

Regularity in reporting ( Timeliness)

Zero reporting

Weakness

Electronic e-Surveillance system not accessible at all levels (from villages, districts, states and central level)

All diseases integrated in a single surveillance but no integrity among the surveillance layers , that’s Syndromic surveillance and Presumptive surveillance don’t have any integrity within themselves

No data modeling and analytical tools

No GIS enabled graphical representations

Opportunities

Can be integrated with other surveillances like WHOs polio surveillance (AFP Surveillance) and Measles and Rubella surveillance

Hierarchy-based feedback & alert mechanisms

Real time, village level, case based data reporting

Community based Syndromic Surveillance through mobile application.

Threats

Gap analysis is happening at district level laboratories only and no gap analysis happening for the program at all levels

Lack of analytical persons at Sub district level, because analysis should be done at all the levels

Data management at Sub Health centers and villages are poor and no data correction happening at sub district level.S