SlideShare ist ein Scribd-Unternehmen logo
1 von 78
Downloaden Sie, um offline zu lesen
Integrated Disease Surveillance
Project (IDSP)
Ebenezer Phesao
Outline
1. Introduction
2. Background history
3. Objectives
4. Organizational set up
5. Funding
6. Project activities
7. Implementation
8. Reports
9. Monitoring and Evaluation
10. Achievements
11. Limitations
12. Conclusion
Introduction
 The disease burden of the people of India is one of the
highest in the world
 India have a triple burden of infectious disease
 Planning for disease prevention and controls depends
upon the disease frequency, distribution and
determinants that can be made available through proper
surveillance
 Surveillance has been identified as backbone of any
health delivery system
Surveillance
 Surveillance is a French word meaning “ Watch
with attention, suspicion and authority”
 Definition: “The ongoing and systematic collection,
analysis and interpretation of health data in the
process of describing and monitoring a health event”
(CDC) OR
WHO definition: “The continuous scrutiny of factors
that determine the occurrence and distribution of
disease and other condition of ill-health”
Surveillance is – “Information for Action”
What are the Key Elements of Surveillance System?
• Detection and notification of health event
• Investigation and confirmation (epidemiological,
clinical, laboratory)
• Collection of data
• Analysis and interpretation of data
• Feed back and dissemination of results
Why do we need to do surveillance?
 To determine incidence of disease
 To know the geographical distribution or spread
of disease
 To identify population at risk of that disease
 To monitor trend of disease over a long time
period
 To capture the factors and condition responsible
for occurrence and spread of disease
 To predict the occurrence of epidemic and control
of epidemic
 To evaluate the effectiveness of an intervention
or programme
Important information in disease surveillance
 Who get the diseases?
 How many get them?
 Where do they get them?
 When do they get them?
 Why do they get them?
 What needs to be done at public health
response?
Pre-requisites for effective surveillance
o Use of standard case definitions
o Ensure regularity of the reports
o Action on the reports
Types of Surveillance in IDSP:
Depending on the level of expertise and specificity, disease
surveillance in IDSP will be of following three categories:
i. Syndromic – Diagnosis made on the basis of
symptoms/clinical pattern by paramedical
personnel and members of the community
ii. Presumptive – Diagnosis made on typical history and clinical
examination by Medical Officers
iii. Confirmed – Clinical diagnosis confirmed by an appropriate
laboratory test
Background history
1. Acute Flaccid Paralysis
2. AIDS
3. Leprosy
4. Malaria: falciparum and vivax
5. Tetanus neonatorum
6. TB
 For these diseases the nation already has national
programs and some sort of surveillance is carried out
under these programs
 One very successful surveillance programme for NCDs
that already exists is the Population based Cancer
Registries
 Other than this there are surveillance systems for
blindness, iodine deficiency, iron deficiency anemia etc.
 The first multiple disease surveillance system in the
country was the NSPCD(National Surveillance
Programme for Communicable Diseases)
 It has laid the foundation for basic surveillance activities
and reporting and responding to outbreaks in the
selected district
 NSPCD(National Surveillance Programme for
Communicable Diseases) Launched in
1997 - 5 districts
1998 - 20 more districts
1999 - 20 more districts
2003 - more 101 districts
2004 to 2010 - IDSP launched
2010 - Extended for 2 more years
The IDSP proposes a comprehensive strategy for
improving disease surveillance and response through an
integrated approach
Types of integration proposed in this project:
Sharing of surveillance information of disease control
programme
Developing effective partnership with health and non-health
sectors in surveillance
Included non- communicable disease in the surveillance
system
Effective partnership of private sectors and NGOs in
surveillance activities
Bringing academic institutions and medical colleges into the
primary public health activity of disease surveillance
Objectives
Goal of IDSP: To provide a rational basis for decision-making and
implementing public health interventions that are efficacious in
responding to priority diseases
Keeping this in mind the main objectives of the IDSP are:
1. To establish a decentralized system of disease surveillance
2. Improve the efficiency of the existing surveillance activities of
disease control programs for use in health planning,
management and evaluating disease control strategies
Specific Objectives:
1) To integrate, coordinate and decentralize surveillance
activities
2) Undertake surveillance for limited number of health
conditions and risk factors
3) To establish system for quality data collection,
reporting, analysis and feedback using IT
4) To improve laboratory support for disease
surveillance
5) To develop human resource for disease surveillance
6) To involve all stake holders including those in private
sector and communities
Organizational Set Up
IDSP
Administrative Structure
NATIONAL SURVEILLANCE COMMITTEE
CENTRAL SURVEILLANCE UNIT
STATE SURVEILLANCE COMMITTEE
STATE SURVEILLANCE UNIT
DISTRICT SURVEILLANCE COMMITTEE
DISTRICT SURVEILLANCE UNIT
 National Centre for Disease Control (NCDC) is
the Nodal Agency for IDSP
Funding
 World Bank
 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 is proposed to continue during 12th Plan as a
Central Sector Scheme under NRHM with outlay of Rs. 851
Crore from domestic budget only
Year Budget estimates
(Rs in crores)
Expenditure
(Rs in crores)
2004-2009 408.36
2009-10 48.50 39.95
2010-11 35.00 28.49
2012-13 63.00
Year Release(in lakhs) Expenditure(in lakhs)
2005-06 94.20
2006-07 1.25
2007-08
2008-09 1.85
Total 94.20 3.10
Balance amount 91.10 lakhs
MANIPUR
Project Activities
 Decentralizing and integrating surveillance mechanisms
 Up gradation of laboratories
 Information technology and communication
 Human resources and development
 Operational activities and response
 Monitoring and evaluation
Implementation
Phasing of IDSP
Andhra Pradesh
Himachal Pradesh
Karnataka
Madhya Pradesh
Maharashtra
Uttrakhand
Tamil Nadu
Mizoram
Kerala
9 STATES
Chhatisgarh
Goa
Gujarat
Haryana
Rajasthan
West Bengal
Manipur
Meghalaya
Orissa
Tripura
Chandigarh
Pondicherry
Delhi
Nagaland
14 STATES/ UTs
Uttar Pradesh
Bihar
Jammu & Kashmir
Jharkhand
Punjab
Arunachal Pradesh
Assam
Sikkim
A & N Nicobar
D & N Haveli
Daman & Diu
Lakshdweep
12 STATES/ UTs
Phase- I (2004-05) Phase- II (2005-06) Phase- III (2006-07)
Diseases and Conditions Covered under IDSP
 Regular Surveillance
 Vector borne diseases
 Malaria
 Water borne diseases
 Acute diarrheal disease, cholera, typhoid
 Respiratory diseases
 Tuberculosis
 Vaccine Preventable Diseases
 Measles
Contd…
Disease under eradication
o polio
Other conditions
o Road traffic accidents
Other international commitments
o Plague, yellow fever
Unusual clinical syndromes
o Meningococcal encephalitis/respiratory
distress/hemorrhagic fevers/ other undiagnosed
conditions
Contd..
 Sentinel surveillance
 STD/Blood borne diseases
 HIV/ HBV/ HCV
 Other conditions
 Water quality, outdoor air quality( large urban area)
 Regular periodic surveys
 NCD risk factors
 Anthropometry, physical activity, blood pressure,
tobacco, nutrition and blindness
 Additional state priorities
 Each state may identify up to five additional conditions
for surveillance e.g. Dengue, Japanese Encephalitis,
Leptospirosis
IDSP Reporting
• Form S ( Suspect Cases) by health workers( sub centers)
• Form P (Probable Cases) by doctors (PHC, CHC,
Hospitals)
• Form L( lab confirmed cases) from laboratories
• Sentinel site and medical college reporting form
• EWS/Outbreak reporting form
• Frequency of reporting -weekly
• Data compilation/analysis and response at all levels
IDSP
IDSP
Information Flow in IDSP
Sub-Centres
P.H.C.s
C.H.C.s
Dist.Hosp.
Pvt. Practitioners
D.S.U.
P.H.Lab.
Med.Co
l.
S.S.U.
C.S.U.
Nursing Homes
Private
Hospitals
Private
Labs.
Strengthening/ Upgradation of Public Health
Laboratories
• Renovation and furnishing of laboratories
• Supply of laboratory equipments & materials
• Focus on 50 identified priority district laboratories
• Quality System + Biosafety
• Avian Influenza network
• Networking of Laboratories
The laboratory network of IDSP
 Peripheral Laboratories and Microscopic centers(L1 labs)
 District Public Health Laboratory(L2 Labs)
 Disease Based State Laboratories (L3 Labs)
 Regional Laboratories (L4 Lab)
 Disease based reference Laboratories (L5 Labs)
Training Activities under IDSP
Trainees Site Days
District and state surveillance team Regional /state 6 days
Laboratory technicians of district and
state public health laboratories
Regional/state 6 days
Data manager of DSU/SSU Regional/state 3 days
Training of laboratory assistants of
CHC/PHC
District HQ 3 days
Data entry operator District HQ 3 days
Mos, Sentinel practitioners, Mos of
sentinel hospitals
District HQ 2 days
HWs, Health assistant, Aganwadi
workers, NGO volunteers, Community
bases staff
CHC 2 days
Human Resources(till 30th June 2011)
Professional Sanctioned
post
In position Trained
Epidemiologist 646 295 269
Microbiologist 85 51 46
Entomologist 35 22 18
Total 766 368 333
IT Network under IDSP
• NIC assigned the task to establish and manage IT network
• ISRO was requested to help in establishing the network for
IDSP for distance education, data entry, data transmission,
video conferencing and out break discussion
• 776 sites (State/ district HQ and Premier institutes) being
connected on Broadband (BSNL)
• 400 sites being connected by broadband as well as satellite
connectivity (ISRO)
Current Usage of IT network
• Video Conferencing held frequently with CSU, State HQ,
selected District HQ and RRT
A weekday wise VC schedule has been started since October
2008, the details as per schedule as under:
Current Usage of IT network
• IDSP portal: It is a single-stop web portal(www.idsp.nic.in) for
data entry and analysis from the district level upwards related
to disease surveillance
• 3 States Gujarat, Maharashtra, Tamilnadu being enabled as
independent networks with State Teaching ends
• Distance learning: Educational satellite (EDUSAT) classrooms
are available at State headquarters, district headquarters,
medical colleges, premier institute and infectious disease
hospitals
Fig: Informatics flow under IDSP
IT Network - Call Centre
• Established in February 2008
• 24X7 Call Centre
• Toll free No. 1075
• Major Regional languages
• Any person would be able to give information about
outbreaks/unusual events on the toll-free number
• Call Centre will refer the information to the concerned
DSU/SSU and the Central Outbreak Monitoring Cell at NICD
• Central Outbreak Monitoring Cell will monitor the actions taken
by concerned District/State Surveillance Officers
Media Scanning Cell
• A Media Scanning and Verification Cell was established at the
NCDC in July200
• Objective:
• To provide the supplemental information about outbreaks
• Method:
• National and local newspapers, Internet surfing, TV channel
screening for news item on disease occurrence.
• Benefits of Media Scanning:
• Increases the sensitivity & strengthen the surveillance
system
• Provide early warning of occurrence of new clusters of
diseases
Reports
Year All 35 States/UTs 9 WB funded States/UTs
2008 553 400 (72%)
2009 799 488 (61%)
2010 990 619 (63%)
2011
(till 26th June )
699 516 (74%)
Total no. of outbreaks reported through IDSP by the
States/UTs in 2008-2011 (till 26th June 2011)
IDSP
Weekly EWS / Outbreak report submitting Status of
States/UTs in 2011 (till 25th week ending on 26th
June)
EWS/OUTBREAK REPORT
SUBMITTING STATUS
STATES / UTs
> 80% times reported
(Consistently and timely reporting)
Andhra Pradesh, Arunachal Pradesh,
Assam, Bihar, Jammu & Kashmir,
Karnataka, Kerala, Madhya Pradesh,
Manipur, Meghalaya, Orissa, Punjab,
Rajasthan, Tamil Nadu, Tripura,
Uttarakhand, West Bengal
50 - 79 % times reported Chandigarh, Daman & Diu, Goa,
Gujarat, Himachal Pradesh,
Maharashtra, Puducherry, Sikkim,
Uttar Pradesh
25 - 49 % times reported Chhattisgarh, Delhi, Haryana,
Nagaland
< 25 % times reported Lakshadweep, Mizoram, Jharkhand
Never reported Andaman & Nicobar, Dadra & Nagar
Haveli
State-wise total no. of outbreaks reported through IDSP by all States/UTs in
2008, 2009, 2010 & 2011 (till 25th wk ending June 26th 2011)
2008 2009 2010 2011
1 Karnataka 54 97 90 110 351
2 Tamil Nadu 50 113 90 49 302
3 West Bengal 49 43 89 90 271
4 Gujarat 24 49 83 101 257
5 Andhra Pradesh 72 64 75 39 250
6 Maharashtra 99 27 65 32 223
7 Uttar Pradesh 40 67 98 10 215
8 Rajasthan 8 43 84 50 185
9 Madhya Pradesh 16 65 70 24 175
10 Assam 16 30 53 39 138
11 Kerala 17 47 53 19 136
12 Orissa 17 38 19 33 107
13 Uttarakhand 27 30 25 21 103
14 Punjab 17 22 18 24 81
15 Bihar 1 6 21 25 53
16 Haryana 10 9 18 7 44
17 Himachal Pradesh 3 13 7 1 24
18 Arunachal Pradesh 6 6 6 5 23
19 Chhattisgarh 1 7 2 4 14
20 Jharkhand 0 5 4 1 10
21 Meghalaya 5 3 2 0 10
22 Tripura 1 2 2 5 10
23 Puducherry 3 2 4 0 9
24 Chandigarh 3 3 2 0 8
25 Sikkim 3 0 2 3 8
26 Delhi 3 1 0 3 7
27 Goa 2 3 0 1 6
28 Manipur 1 2 2 1 6
29 Mizoram 5 0 0 0 5
30 Jammu & Kashmir 0 0 2 2 4
31 Nagaland 0 1 2 0 3
32 Daman & Diu 0 1 1 0 2
33 Dadra and Nagar Haveli 0 0 1 0 1
34 Andaman & Nicobar 0 0 0 0 0
35 Lakshadweep 0 0 0 0 0
553 799 990 699 3041
Total
Year
Sl. No. State Total
Disease-wise total no. of outbreaks reported through IDSP by all
States in 2008, 2009, 2010 & 2011 (till 25th wk ending June 26th)
2008 2009 2010 2011
1 Acute Diarrhoeal Disease 228 332 411 220 1191
2 Food Poisoning 50 121 188 158 517
3 Measles 40 44 94 103 281
4 Chicken Pox 12 45 47 47 151
5 Malaria 43 34 37 23 137
6 Viral Hepatitis 28 30 24 46 128
7 Viral Fever 31 37 40 16 124
8 Chikungunya 25 61 25 12 123
9 Dengue 42 20 40 14 116
10 Cholera 20 34 34 22 110
11 Enteric Fever 6 10 10 4 30
12 Acute Encephalitis Syndrome 6 5 11 6 28
13 Anthrax 2 6 3 6 17
14 Leptospirosis 6 3 6 1 16
15 Acute Respiratory Illness 4 3 3 1 11
16 Dysentery 0 1 3 3 7
17 Kalazar 1 0 3 3 7
18 Meningitis 2 3 1 1 7
19 Scrub Typhus 3 1 1 2 7
20 Acute Flaccid Paralysis 1 0 0 5 6
21 Mumps 0 2 3 1 6
22 PUO 1 2 1 0 4
23 Diphtheria 1 1 1 0 3
24 Rubella 0 1 2 0 3
25 Cremian-Congo Haemorrhagic Fever 0 0 0 2 2
26 Gas Poisoning 0 1 0 1 2
27 Acute Febrile Illness 1 0 0 0 1
28 Buffalo pox 0 1 0 0 1
29 Epidemic dropsy 0 0 1 0 1
30 Kyasanur Forest Disease 0 0 0 1 1
31 Pertussis 0 0 1 0 1
32 Viral Hepatitis B 0 1 0 0 1
33 Vitamin A Overdosage 0 0 0 1 1
553 799 990 699 3041
Year
Sl. No. Disease/Illness Total
Total
IDSP status of Tripura
• SSU and DSU was set up in 2005-2006
• Total DSU is 4
• Total reporting site: 802
• Every week – 630 sub-center, 91 government/ private
laboratories and 107 PHC/CHC are reporting in S, P, L
format
• Training status:
Medical officer & doctors 420
MPS 20
MPW 658
Lab technician 90
• 3 DSU and SSU is equipped with EDUSAT
• SSU is having the facility of video conferencing with
CCU
• RGM Hospt, North Tripura – identified as District Priority
Lab
• Contractual Staff position under IDSP as on June, 2012
Designation Number
Consultant (Finance) 1
Data entry operator 4
Professional Sanctioned
post
In position Trained
Epidemiologist 5 0 0
Microbiologist 2 0 0
Entomologist 1 0 0
Total 8 0 0
Human resource for Tripura
IDSP status of Manipur
• Manipur is a phase II state under IDSP
Human resource for Manipur (till 30 th June 2011)
Professional Sanctioned
post
In position Trained
Epidemiologist 10 3 3
Microbiologist 2 0 0
Entomologist 1 0 0
Total 13 3 3
• Outbreak and epidemic after introduction of
IDSP in Manipur
Outbreak Place and time
Dengue Moreh in Dec 2007
Scrub Typhus Bishnupur in April 2008
malaria Churachandpur In March 2009
Malaria Moreh in April to July 2009
Malaria Touthong Khunou in June 2009
German measles Khurai, Imphal East in May
2009
Japanese encephalitis June-July 2010
• RRT in every district is in position to response to any out
break
• 7 CMOs and 2 DSOs have been trained on FETP in
2010
• An innovation EWS reporting by using SMS from
periphery to district and state surveillance was
introduced in the 2011-2012 session
• Informer will be given Rs 70 recharge card / month
• Sentinel surveillance of the Vaccine preventable
childhood infectious disease started in JNIMS in 2010-11
• District priority laboratory at District hospital
Churachandpur has been fully equipped and is ready to
function
• The daily newspaper and e-mail scanning was
introduced in the 2011-2012 financial year
• SIT equipments installed at State Headquarter, 9 DSUs
and Regional Institute of Medical Sciences, Imphal
• Manipur has 9 districts. Four out of nine DSUs are
reporting weekly data and outbreak report regularly
 Total DSU: 11
 No. of DSU equipped with EDUSAT- 10
Status: Non-functional
 New diseases detected after introduction of IDSP:
JE, Dengue, Scrub Typhus, Kala Azar
(migrant)
 IDSP Priority Lab- 2
IDSP Status in Nagaland
 No of RRT : 3
 24 X 7 call centre established after detection
of swine flu case in Nagaland
 Sentinel surveillance – not done
 Media scanning cell: 1 national and 3 local
newspaper screened everyday
 Account in Facebook as Nagaland IDSP opened
 DSU reporting: regular but completeness lacking
Human Resources for Nagaland
Professional Sanctioned
post
In position Trained
Epidemiologist 9 7 7
Microbiologist 3 3 3
Entomologist 1 1 1
Total 13 11 11
1. Training of Trainers (TOT) -15
2. Orientation of District Surveillance
Officers (DSOs) done - 11
3. Medical Officers - 92
4. Lab. Tech/ Asst. - 41
5. MPWs - 431
6. Accountants(IDSP) - 11
7. DEOs - 24
8. Sensitization of Private Practitioners/ Paramilitary
done for all Districts
Training programme for 2012:
Field Epidemiological Training Programme(FETP) – target achieved
Training of Trainers(TOT) – target achieved
Training of MO and Para- medical staffs – not yet done
Monitoring
Key Performance Indicators
 Number and percentage of districts providing monthly
surveillance reports on time – by state and overall
 Number and percentage of responses to disease-specific
triggers on time - by state and overall
 Number and percentage of responses to disease-specific
triggers assessed to be adequate -by state and overall
 Number and percentage of laboratories providing
adequate quality of information – by state and center
Contd.
 Number of districts in which private providers are
contributing to disease information
 Number of reports derived from private health care
providers
 Number of reports derived from private laboratories
 Number and percentage of states in which surveillance
information relating to various vertical disease control
programs have been integrated
Contd.
 Number and percentage of project districts and states
publishing annual surveillance reports within three
months of the end of the fiscal year
 Publication by CSU of consolidated annual
surveillance report (print, electronic, including posting
on the websites) within three months of the end of
fiscal year
Achievements
• Surveillance units have been established in all states/districts
(SSU/DSU)
• 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
Contd.
• On an average, 20-30 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
and 1675 outbreaks in 2011. In 2012, 482 outbreaks have
been reported till 29th April
• A total of 1758 media alerts were reported from July 2008
to March 2012
• About 2.7 lakh calls have been received from beginning till
now, out of which more than thirty five thousand calls were
related to Influenza A H1N1
• 50 identified district laboratories are being strengthened for
diagnosis of epidemic prone diseases and a network of 12
laboratories has been developed for Influenza surveillance
in the country
Contd.
• In 9 States, a referral lab network has been established
• Recruitment of 301 Epidemiologists, 60 Microbiologists and
23 Entomologists has been completed so far
Limitations
• The project was launched throughout the county but on
papers and no training of professionals and staff involved in
data collection and transmission has been completed
• The project started in 2005-06 but functional software was
shared during end of 2008, thereby leading to gaps in data
entry, data-basing and analysis
• Difficulty in ensuring the quality of training in a cascade
method
• Lack of trained epidemiologist and microbiologist
• Trained District Surveillance Officers have not been able
to use their skills due to high turnover. In addition, the
district surveillance officer has multiple responsibilities
• Involvement of Medical Colleges (In the first PIP there
was no provision for training, outbreak investigation and
contingencies etc. for Medical Colleges)
• Funds committed for medical college laboratory to act
as State Reference Laboratory were not available.
• District Laboratories do not have the
infrastructure/manpower with adequate skills for
undertaking confirmatory tests for a number of diseases
• Broadband connection installation and maintenance of
VC was centrally coordinated, as a result of which minor
defects could not be rectified locally and Data Managers
were not trained enough to rectify the defects
• At the time of disaster, SSU and State Health Control
Room operate in the same office because of which the
routine surveillance gets diluted
• Public Health which gets activated only during the time
of disaster and crisis is yet to get its due place in day to
day functioning of the health system
• Lack of monitoring and supervision at all levels
• Private sectors and semi-government organization have
not been involved in the same proportion as of their
numbers
• Number of parallel systems under various programs are
still operating and duplication of record generation has
not gone down
Conclusion
 Integrated Disease Surveillance Project (IDSP) is a
decentralized, state based surveillance programme in the
country
 It is intended to detect early warning signals of impending
outbreaks and help initiate an effective response in a
timely manner
 It is also expected to provide essential data to monitor
progress of on-going disease control programmes and
help allocate health resources more efficiently
Thank You

Weitere ähnliche Inhalte

Was ist angesagt?

National Leprosy Eradication Programme (NLEP)
National Leprosy Eradication Programme (NLEP)National Leprosy Eradication Programme (NLEP)
National Leprosy Eradication Programme (NLEP)Sneha Gaurkar
 
National leprosy eradication program
National leprosy eradication programNational leprosy eradication program
National leprosy eradication programswati shikha
 
National framework for malaria elimination in india
National framework for malaria elimination in indiaNational framework for malaria elimination in india
National framework for malaria elimination in indiaAparna Chaudhary
 
National cancer control programme
National cancer control programmeNational cancer control programme
National cancer control programmeanjalatchi
 
National AIDS control programme ppt
National AIDS control programme pptNational AIDS control programme ppt
National AIDS control programme pptKomalSingh811671
 
National AIDS Control Program - IV
National AIDS Control Program - IVNational AIDS Control Program - IV
National AIDS Control Program - IVBharat Paul
 
Universal Immunization Program
Universal Immunization ProgramUniversal Immunization Program
Universal Immunization ProgramPriyanka Ch
 
NACP IV Critical analysis
NACP IV Critical analysisNACP IV Critical analysis
NACP IV Critical analysisDrArundas
 

Was ist angesagt? (20)

Nuhm
NuhmNuhm
Nuhm
 
Indian public health standards
Indian public health standardsIndian public health standards
Indian public health standards
 
Nacp iv ppt
Nacp iv pptNacp iv ppt
Nacp iv ppt
 
National Leprosy Eradication Programme (NLEP)
National Leprosy Eradication Programme (NLEP)National Leprosy Eradication Programme (NLEP)
National Leprosy Eradication Programme (NLEP)
 
National leprosy eradication program
National leprosy eradication programNational leprosy eradication program
National leprosy eradication program
 
National framework for malaria elimination in india
National framework for malaria elimination in indiaNational framework for malaria elimination in india
National framework for malaria elimination in india
 
Npcdcs ppt
Npcdcs pptNpcdcs ppt
Npcdcs ppt
 
National cancer control programme
National cancer control programmeNational cancer control programme
National cancer control programme
 
IDSP- Dr. Dharmendra Gahwai
IDSP- Dr. Dharmendra GahwaiIDSP- Dr. Dharmendra Gahwai
IDSP- Dr. Dharmendra Gahwai
 
Malaria Control Program in Nepal
Malaria Control Program in NepalMalaria Control Program in Nepal
Malaria Control Program in Nepal
 
Ayushman Bharat Yojana National Health Protection Scheme
Ayushman Bharat Yojana  National Health Protection Scheme Ayushman Bharat Yojana  National Health Protection Scheme
Ayushman Bharat Yojana National Health Protection Scheme
 
National AIDS control programme ppt
National AIDS control programme pptNational AIDS control programme ppt
National AIDS control programme ppt
 
NVBDCP 2019
NVBDCP 2019NVBDCP 2019
NVBDCP 2019
 
National Urban Health Mission
National Urban Health MissionNational Urban Health Mission
National Urban Health Mission
 
National AIDS Control Program - IV
National AIDS Control Program - IVNational AIDS Control Program - IV
National AIDS Control Program - IV
 
Malaria program
Malaria programMalaria program
Malaria program
 
CANCER CONTROL PROGRAMME-INDIA
CANCER CONTROL PROGRAMME-INDIACANCER CONTROL PROGRAMME-INDIA
CANCER CONTROL PROGRAMME-INDIA
 
AIDS CONTROL PROGRAMME
AIDS CONTROL PROGRAMMEAIDS CONTROL PROGRAMME
AIDS CONTROL PROGRAMME
 
Universal Immunization Program
Universal Immunization ProgramUniversal Immunization Program
Universal Immunization Program
 
NACP IV Critical analysis
NACP IV Critical analysisNACP IV Critical analysis
NACP IV Critical analysis
 

Andere mochten auch

Critical review of idsp
Critical review of idspCritical review of idsp
Critical review of idspAbhi Manu
 
IDSP-a critical analysis
IDSP-a critical analysisIDSP-a critical analysis
IDSP-a critical analysisGnanaranjan Das
 
central government health scheme
central government health scheme  central government health scheme
central government health scheme Pranav Goyal
 
Health Information Systems
Health Information SystemsHealth Information Systems
Health Information SystemsNikhil Agarwal
 
International health regulation
International health regulationInternational health regulation
International health regulationVenu Bolisetti
 
Intorduction to Health information system presentation
 Intorduction to Health information system presentation Intorduction to Health information system presentation
Intorduction to Health information system presentationAkumengwa
 
Primary health care in India
Primary health care in IndiaPrimary health care in India
Primary health care in IndiaRakesh Verma
 
Primary health care in india
Primary health care in indiaPrimary health care in india
Primary health care in indiaPradip Awate
 
Prevention ppt
Prevention pptPrevention ppt
Prevention pptSandhya M
 
Health Insurance Presentation
Health Insurance PresentationHealth Insurance Presentation
Health Insurance PresentationDEEPAK TIWARI
 
Reproductive and child health programme
Reproductive and child health programmeReproductive and child health programme
Reproductive and child health programmeThomaskutty Saji
 
PPT on "Employee's State Insurance Act 1948" of India.
PPT on "Employee's State Insurance Act 1948" of India.PPT on "Employee's State Insurance Act 1948" of India.
PPT on "Employee's State Insurance Act 1948" of India.Anshu Shekhar Singh
 
Occupational health ppt
Occupational health pptOccupational health ppt
Occupational health pptrenubasent
 

Andere mochten auch (20)

Critical review of idsp
Critical review of idspCritical review of idsp
Critical review of idsp
 
IDSP-a critical analysis
IDSP-a critical analysisIDSP-a critical analysis
IDSP-a critical analysis
 
central government health scheme
central government health scheme  central government health scheme
central government health scheme
 
Epidemiology ppt
Epidemiology pptEpidemiology ppt
Epidemiology ppt
 
Health scheme
Health schemeHealth scheme
Health scheme
 
Health Information Systems
Health Information SystemsHealth Information Systems
Health Information Systems
 
International health regulation
International health regulationInternational health regulation
International health regulation
 
Surveillance
SurveillanceSurveillance
Surveillance
 
Intorduction to Health information system presentation
 Intorduction to Health information system presentation Intorduction to Health information system presentation
Intorduction to Health information system presentation
 
Primary health care in India
Primary health care in IndiaPrimary health care in India
Primary health care in India
 
Presentation of health policies
Presentation of health policiesPresentation of health policies
Presentation of health policies
 
Primary health care in india
Primary health care in indiaPrimary health care in india
Primary health care in india
 
Surveillance
SurveillanceSurveillance
Surveillance
 
National health policy
National health policy National health policy
National health policy
 
Prevention ppt
Prevention pptPrevention ppt
Prevention ppt
 
Health Insurance Presentation
Health Insurance PresentationHealth Insurance Presentation
Health Insurance Presentation
 
Surveillance
SurveillanceSurveillance
Surveillance
 
Reproductive and child health programme
Reproductive and child health programmeReproductive and child health programme
Reproductive and child health programme
 
PPT on "Employee's State Insurance Act 1948" of India.
PPT on "Employee's State Insurance Act 1948" of India.PPT on "Employee's State Insurance Act 1948" of India.
PPT on "Employee's State Insurance Act 1948" of India.
 
Occupational health ppt
Occupational health pptOccupational health ppt
Occupational health ppt
 

Ähnlich wie IDSP

Workshop 3 - "Feedback from the 15 National Conferences on Registries"
Workshop 3 - "Feedback from the 15 National Conferences on Registries" Workshop 3 - "Feedback from the 15 National Conferences on Registries"
Workshop 3 - "Feedback from the 15 National Conferences on Registries" EURORDIS - Rare Diseases Europe
 
Role of Information and Communication Technology in Medical Resaerch: A Natio...
Role of Information and Communication Technology in Medical Resaerch: A Natio...Role of Information and Communication Technology in Medical Resaerch: A Natio...
Role of Information and Communication Technology in Medical Resaerch: A Natio...Apollo Hospitals Group and ATNF
 
SURVEILLANCE OF HEALTH EVENT
SURVEILLANCE OF HEALTH EVENTSURVEILLANCE OF HEALTH EVENT
SURVEILLANCE OF HEALTH EVENTAneesa K Ayoob
 
EHR- 2016 Eeshika Mitra
EHR- 2016 Eeshika MitraEHR- 2016 Eeshika Mitra
EHR- 2016 Eeshika MitraEeshika Mitra
 
Integrated Health Information Platform (IHIP)
Integrated Health Information Platform (IHIP)Integrated Health Information Platform (IHIP)
Integrated Health Information Platform (IHIP)ssuser57d97d
 
Risk factor surveillance of Non-communicable diseases
Risk factor surveillance of Non-communicable diseasesRisk factor surveillance of Non-communicable diseases
Risk factor surveillance of Non-communicable diseasesVineetha K
 
INTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptx
INTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptxINTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptx
INTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptxSanjeevDavey1
 
Cadth symposium 2015 d3 pro presentation apr 2015 - for deb
Cadth symposium 2015 d3 pro presentation   apr 2015 - for debCadth symposium 2015 d3 pro presentation   apr 2015 - for deb
Cadth symposium 2015 d3 pro presentation apr 2015 - for debCADTH Symposium
 
SURVEILLANCE LECTURE.pptx
SURVEILLANCE LECTURE.pptxSURVEILLANCE LECTURE.pptx
SURVEILLANCE LECTURE.pptxMittal Rathod
 
Revised stratplan-nhln
Revised stratplan-nhlnRevised stratplan-nhln
Revised stratplan-nhlnJOHNALFREY
 
Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...
  Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...  Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...
Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...HIMSS UK
 
Real Time Research in a Singapore Public Primary Care Institution
Real Time Research in a Singapore Public Primary Care InstitutionReal Time Research in a Singapore Public Primary Care Institution
Real Time Research in a Singapore Public Primary Care InstitutionZoe Mitchell
 
Med peds noon conference feb 2011
Med peds noon conference feb 2011Med peds noon conference feb 2011
Med peds noon conference feb 2011nyayahealth
 
Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011
Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011
Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011nyayahealth
 

Ähnlich wie IDSP (20)

Integrated surveillance for communicable diseases
Integrated surveillance for communicable diseasesIntegrated surveillance for communicable diseases
Integrated surveillance for communicable diseases
 
Surveillance
SurveillanceSurveillance
Surveillance
 
Workshop 3 - "Feedback from the 15 National Conferences on Registries"
Workshop 3 - "Feedback from the 15 National Conferences on Registries" Workshop 3 - "Feedback from the 15 National Conferences on Registries"
Workshop 3 - "Feedback from the 15 National Conferences on Registries"
 
Role of Information and Communication Technology in Medical Resaerch: A Natio...
Role of Information and Communication Technology in Medical Resaerch: A Natio...Role of Information and Communication Technology in Medical Resaerch: A Natio...
Role of Information and Communication Technology in Medical Resaerch: A Natio...
 
SURVEILLANCE OF HEALTH EVENT
SURVEILLANCE OF HEALTH EVENTSURVEILLANCE OF HEALTH EVENT
SURVEILLANCE OF HEALTH EVENT
 
EHR- 2016 Eeshika Mitra
EHR- 2016 Eeshika MitraEHR- 2016 Eeshika Mitra
EHR- 2016 Eeshika Mitra
 
Integrated Health Information Platform (IHIP)
Integrated Health Information Platform (IHIP)Integrated Health Information Platform (IHIP)
Integrated Health Information Platform (IHIP)
 
Risk factor surveillance of Non-communicable diseases
Risk factor surveillance of Non-communicable diseasesRisk factor surveillance of Non-communicable diseases
Risk factor surveillance of Non-communicable diseases
 
INTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptx
INTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptxINTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptx
INTRO HIV SURVEILLANCE PROF DR SANJEV DAVE.pptx
 
Cadth symposium 2015 d3 pro presentation apr 2015 - for deb
Cadth symposium 2015 d3 pro presentation   apr 2015 - for debCadth symposium 2015 d3 pro presentation   apr 2015 - for deb
Cadth symposium 2015 d3 pro presentation apr 2015 - for deb
 
SURVEILLANCE LECTURE.pptx
SURVEILLANCE LECTURE.pptxSURVEILLANCE LECTURE.pptx
SURVEILLANCE LECTURE.pptx
 
Revised stratplan-nhln
Revised stratplan-nhlnRevised stratplan-nhln
Revised stratplan-nhln
 
Hmis
HmisHmis
Hmis
 
Mie2000
Mie2000Mie2000
Mie2000
 
Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...
  Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...  Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...
Brendan Delany – Chair in Medical Informatics and Decision Making, Imperial...
 
Real Time Research in a Singapore Public Primary Care Institution
Real Time Research in a Singapore Public Primary Care InstitutionReal Time Research in a Singapore Public Primary Care Institution
Real Time Research in a Singapore Public Primary Care Institution
 
Med peds noon conference feb 2011
Med peds noon conference feb 2011Med peds noon conference feb 2011
Med peds noon conference feb 2011
 
Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011
Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011
Harvard Internal Medicine-Pediatrics Noon Conference Feb 3, 2011
 
public health surveillance
public health surveillance public health surveillance
public health surveillance
 
His
HisHis
His
 

Kürzlich hochgeladen

How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxMAsifAhmad
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyMedicoseAcademics
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 

Kürzlich hochgeladen (20)

How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before Pregnancy
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 

IDSP

  • 2. Outline 1. Introduction 2. Background history 3. Objectives 4. Organizational set up 5. Funding 6. Project activities 7. Implementation 8. Reports 9. Monitoring and Evaluation 10. Achievements 11. Limitations 12. Conclusion
  • 4.  The disease burden of the people of India is one of the highest in the world  India have a triple burden of infectious disease  Planning for disease prevention and controls depends upon the disease frequency, distribution and determinants that can be made available through proper surveillance  Surveillance has been identified as backbone of any health delivery system
  • 5. Surveillance  Surveillance is a French word meaning “ Watch with attention, suspicion and authority”  Definition: “The ongoing and systematic collection, analysis and interpretation of health data in the process of describing and monitoring a health event” (CDC) OR WHO definition: “The continuous scrutiny of factors that determine the occurrence and distribution of disease and other condition of ill-health” Surveillance is – “Information for Action”
  • 6. What are the Key Elements of Surveillance System? • Detection and notification of health event • Investigation and confirmation (epidemiological, clinical, laboratory) • Collection of data • Analysis and interpretation of data • Feed back and dissemination of results
  • 7. Why do we need to do surveillance?  To determine incidence of disease  To know the geographical distribution or spread of disease  To identify population at risk of that disease  To monitor trend of disease over a long time period  To capture the factors and condition responsible for occurrence and spread of disease  To predict the occurrence of epidemic and control of epidemic  To evaluate the effectiveness of an intervention or programme
  • 8. Important information in disease surveillance  Who get the diseases?  How many get them?  Where do they get them?  When do they get them?  Why do they get them?  What needs to be done at public health response?
  • 9. Pre-requisites for effective surveillance o Use of standard case definitions o Ensure regularity of the reports o Action on the reports Types of Surveillance in IDSP: Depending on the level of expertise and specificity, disease surveillance in IDSP will be of following three categories: i. Syndromic – Diagnosis made on the basis of symptoms/clinical pattern by paramedical personnel and members of the community ii. Presumptive – Diagnosis made on typical history and clinical examination by Medical Officers iii. Confirmed – Clinical diagnosis confirmed by an appropriate laboratory test
  • 11. 1. Acute Flaccid Paralysis 2. AIDS 3. Leprosy 4. Malaria: falciparum and vivax 5. Tetanus neonatorum 6. TB  For these diseases the nation already has national programs and some sort of surveillance is carried out under these programs
  • 12.  One very successful surveillance programme for NCDs that already exists is the Population based Cancer Registries  Other than this there are surveillance systems for blindness, iodine deficiency, iron deficiency anemia etc.  The first multiple disease surveillance system in the country was the NSPCD(National Surveillance Programme for Communicable Diseases)  It has laid the foundation for basic surveillance activities and reporting and responding to outbreaks in the selected district
  • 13.  NSPCD(National Surveillance Programme for Communicable Diseases) Launched in 1997 - 5 districts 1998 - 20 more districts 1999 - 20 more districts 2003 - more 101 districts 2004 to 2010 - IDSP launched 2010 - Extended for 2 more years The IDSP proposes a comprehensive strategy for improving disease surveillance and response through an integrated approach
  • 14. Types of integration proposed in this project: Sharing of surveillance information of disease control programme Developing effective partnership with health and non-health sectors in surveillance Included non- communicable disease in the surveillance system Effective partnership of private sectors and NGOs in surveillance activities Bringing academic institutions and medical colleges into the primary public health activity of disease surveillance
  • 16. Goal of IDSP: To provide a rational basis for decision-making and implementing public health interventions that are efficacious in responding to priority diseases Keeping this in mind the main objectives of the IDSP are: 1. To establish a decentralized system of disease surveillance 2. Improve the efficiency of the existing surveillance activities of disease control programs for use in health planning, management and evaluating disease control strategies
  • 17. Specific Objectives: 1) To integrate, coordinate and decentralize surveillance activities 2) Undertake surveillance for limited number of health conditions and risk factors 3) To establish system for quality data collection, reporting, analysis and feedback using IT 4) To improve laboratory support for disease surveillance 5) To develop human resource for disease surveillance 6) To involve all stake holders including those in private sector and communities
  • 20. Administrative Structure NATIONAL SURVEILLANCE COMMITTEE CENTRAL SURVEILLANCE UNIT STATE SURVEILLANCE COMMITTEE STATE SURVEILLANCE UNIT DISTRICT SURVEILLANCE COMMITTEE DISTRICT SURVEILLANCE UNIT  National Centre for Disease Control (NCDC) is the Nodal Agency for IDSP
  • 22.  World Bank  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 is proposed to continue during 12th Plan as a Central Sector Scheme under NRHM with outlay of Rs. 851 Crore from domestic budget only
  • 23. Year Budget estimates (Rs in crores) Expenditure (Rs in crores) 2004-2009 408.36 2009-10 48.50 39.95 2010-11 35.00 28.49 2012-13 63.00 Year Release(in lakhs) Expenditure(in lakhs) 2005-06 94.20 2006-07 1.25 2007-08 2008-09 1.85 Total 94.20 3.10 Balance amount 91.10 lakhs MANIPUR
  • 25.  Decentralizing and integrating surveillance mechanisms  Up gradation of laboratories  Information technology and communication  Human resources and development  Operational activities and response  Monitoring and evaluation
  • 27. Phasing of IDSP Andhra Pradesh Himachal Pradesh Karnataka Madhya Pradesh Maharashtra Uttrakhand Tamil Nadu Mizoram Kerala 9 STATES Chhatisgarh Goa Gujarat Haryana Rajasthan West Bengal Manipur Meghalaya Orissa Tripura Chandigarh Pondicherry Delhi Nagaland 14 STATES/ UTs Uttar Pradesh Bihar Jammu & Kashmir Jharkhand Punjab Arunachal Pradesh Assam Sikkim A & N Nicobar D & N Haveli Daman & Diu Lakshdweep 12 STATES/ UTs Phase- I (2004-05) Phase- II (2005-06) Phase- III (2006-07)
  • 28. Diseases and Conditions Covered under IDSP  Regular Surveillance  Vector borne diseases  Malaria  Water borne diseases  Acute diarrheal disease, cholera, typhoid  Respiratory diseases  Tuberculosis  Vaccine Preventable Diseases  Measles
  • 29. Contd… Disease under eradication o polio Other conditions o Road traffic accidents Other international commitments o Plague, yellow fever Unusual clinical syndromes o Meningococcal encephalitis/respiratory distress/hemorrhagic fevers/ other undiagnosed conditions
  • 30. Contd..  Sentinel surveillance  STD/Blood borne diseases  HIV/ HBV/ HCV  Other conditions  Water quality, outdoor air quality( large urban area)  Regular periodic surveys  NCD risk factors  Anthropometry, physical activity, blood pressure, tobacco, nutrition and blindness  Additional state priorities  Each state may identify up to five additional conditions for surveillance e.g. Dengue, Japanese Encephalitis, Leptospirosis
  • 31. IDSP Reporting • Form S ( Suspect Cases) by health workers( sub centers) • Form P (Probable Cases) by doctors (PHC, CHC, Hospitals) • Form L( lab confirmed cases) from laboratories • Sentinel site and medical college reporting form • EWS/Outbreak reporting form • Frequency of reporting -weekly • Data compilation/analysis and response at all levels
  • 34. Information Flow in IDSP Sub-Centres P.H.C.s C.H.C.s Dist.Hosp. Pvt. Practitioners D.S.U. P.H.Lab. Med.Co l. S.S.U. C.S.U. Nursing Homes Private Hospitals Private Labs.
  • 35. Strengthening/ Upgradation of Public Health Laboratories • Renovation and furnishing of laboratories • Supply of laboratory equipments & materials • Focus on 50 identified priority district laboratories • Quality System + Biosafety • Avian Influenza network • Networking of Laboratories
  • 36. The laboratory network of IDSP  Peripheral Laboratories and Microscopic centers(L1 labs)  District Public Health Laboratory(L2 Labs)  Disease Based State Laboratories (L3 Labs)  Regional Laboratories (L4 Lab)  Disease based reference Laboratories (L5 Labs)
  • 37. Training Activities under IDSP Trainees Site Days District and state surveillance team Regional /state 6 days Laboratory technicians of district and state public health laboratories Regional/state 6 days Data manager of DSU/SSU Regional/state 3 days Training of laboratory assistants of CHC/PHC District HQ 3 days Data entry operator District HQ 3 days Mos, Sentinel practitioners, Mos of sentinel hospitals District HQ 2 days HWs, Health assistant, Aganwadi workers, NGO volunteers, Community bases staff CHC 2 days
  • 38. Human Resources(till 30th June 2011) Professional Sanctioned post In position Trained Epidemiologist 646 295 269 Microbiologist 85 51 46 Entomologist 35 22 18 Total 766 368 333
  • 39. IT Network under IDSP • NIC assigned the task to establish and manage IT network • ISRO was requested to help in establishing the network for IDSP for distance education, data entry, data transmission, video conferencing and out break discussion • 776 sites (State/ district HQ and Premier institutes) being connected on Broadband (BSNL) • 400 sites being connected by broadband as well as satellite connectivity (ISRO)
  • 40. Current Usage of IT network • Video Conferencing held frequently with CSU, State HQ, selected District HQ and RRT A weekday wise VC schedule has been started since October 2008, the details as per schedule as under:
  • 41. Current Usage of IT network • IDSP portal: It is a single-stop web portal(www.idsp.nic.in) for data entry and analysis from the district level upwards related to disease surveillance • 3 States Gujarat, Maharashtra, Tamilnadu being enabled as independent networks with State Teaching ends • Distance learning: Educational satellite (EDUSAT) classrooms are available at State headquarters, district headquarters, medical colleges, premier institute and infectious disease hospitals
  • 42. Fig: Informatics flow under IDSP
  • 43. IT Network - Call Centre • Established in February 2008 • 24X7 Call Centre • Toll free No. 1075 • Major Regional languages • Any person would be able to give information about outbreaks/unusual events on the toll-free number • Call Centre will refer the information to the concerned DSU/SSU and the Central Outbreak Monitoring Cell at NICD • Central Outbreak Monitoring Cell will monitor the actions taken by concerned District/State Surveillance Officers
  • 44. Media Scanning Cell • A Media Scanning and Verification Cell was established at the NCDC in July200 • Objective: • To provide the supplemental information about outbreaks • Method: • National and local newspapers, Internet surfing, TV channel screening for news item on disease occurrence. • Benefits of Media Scanning: • Increases the sensitivity & strengthen the surveillance system • Provide early warning of occurrence of new clusters of diseases
  • 46. Year All 35 States/UTs 9 WB funded States/UTs 2008 553 400 (72%) 2009 799 488 (61%) 2010 990 619 (63%) 2011 (till 26th June ) 699 516 (74%) Total no. of outbreaks reported through IDSP by the States/UTs in 2008-2011 (till 26th June 2011)
  • 48. Weekly EWS / Outbreak report submitting Status of States/UTs in 2011 (till 25th week ending on 26th June) EWS/OUTBREAK REPORT SUBMITTING STATUS STATES / UTs > 80% times reported (Consistently and timely reporting) Andhra Pradesh, Arunachal Pradesh, Assam, Bihar, Jammu & Kashmir, Karnataka, Kerala, Madhya Pradesh, Manipur, Meghalaya, Orissa, Punjab, Rajasthan, Tamil Nadu, Tripura, Uttarakhand, West Bengal 50 - 79 % times reported Chandigarh, Daman & Diu, Goa, Gujarat, Himachal Pradesh, Maharashtra, Puducherry, Sikkim, Uttar Pradesh 25 - 49 % times reported Chhattisgarh, Delhi, Haryana, Nagaland < 25 % times reported Lakshadweep, Mizoram, Jharkhand Never reported Andaman & Nicobar, Dadra & Nagar Haveli
  • 49. State-wise total no. of outbreaks reported through IDSP by all States/UTs in 2008, 2009, 2010 & 2011 (till 25th wk ending June 26th 2011) 2008 2009 2010 2011 1 Karnataka 54 97 90 110 351 2 Tamil Nadu 50 113 90 49 302 3 West Bengal 49 43 89 90 271 4 Gujarat 24 49 83 101 257 5 Andhra Pradesh 72 64 75 39 250 6 Maharashtra 99 27 65 32 223 7 Uttar Pradesh 40 67 98 10 215 8 Rajasthan 8 43 84 50 185 9 Madhya Pradesh 16 65 70 24 175 10 Assam 16 30 53 39 138 11 Kerala 17 47 53 19 136 12 Orissa 17 38 19 33 107 13 Uttarakhand 27 30 25 21 103 14 Punjab 17 22 18 24 81 15 Bihar 1 6 21 25 53 16 Haryana 10 9 18 7 44 17 Himachal Pradesh 3 13 7 1 24 18 Arunachal Pradesh 6 6 6 5 23 19 Chhattisgarh 1 7 2 4 14 20 Jharkhand 0 5 4 1 10 21 Meghalaya 5 3 2 0 10 22 Tripura 1 2 2 5 10 23 Puducherry 3 2 4 0 9 24 Chandigarh 3 3 2 0 8 25 Sikkim 3 0 2 3 8 26 Delhi 3 1 0 3 7 27 Goa 2 3 0 1 6 28 Manipur 1 2 2 1 6 29 Mizoram 5 0 0 0 5 30 Jammu & Kashmir 0 0 2 2 4 31 Nagaland 0 1 2 0 3 32 Daman & Diu 0 1 1 0 2 33 Dadra and Nagar Haveli 0 0 1 0 1 34 Andaman & Nicobar 0 0 0 0 0 35 Lakshadweep 0 0 0 0 0 553 799 990 699 3041 Total Year Sl. No. State Total
  • 50. Disease-wise total no. of outbreaks reported through IDSP by all States in 2008, 2009, 2010 & 2011 (till 25th wk ending June 26th) 2008 2009 2010 2011 1 Acute Diarrhoeal Disease 228 332 411 220 1191 2 Food Poisoning 50 121 188 158 517 3 Measles 40 44 94 103 281 4 Chicken Pox 12 45 47 47 151 5 Malaria 43 34 37 23 137 6 Viral Hepatitis 28 30 24 46 128 7 Viral Fever 31 37 40 16 124 8 Chikungunya 25 61 25 12 123 9 Dengue 42 20 40 14 116 10 Cholera 20 34 34 22 110 11 Enteric Fever 6 10 10 4 30 12 Acute Encephalitis Syndrome 6 5 11 6 28 13 Anthrax 2 6 3 6 17 14 Leptospirosis 6 3 6 1 16 15 Acute Respiratory Illness 4 3 3 1 11 16 Dysentery 0 1 3 3 7 17 Kalazar 1 0 3 3 7 18 Meningitis 2 3 1 1 7 19 Scrub Typhus 3 1 1 2 7 20 Acute Flaccid Paralysis 1 0 0 5 6 21 Mumps 0 2 3 1 6 22 PUO 1 2 1 0 4 23 Diphtheria 1 1 1 0 3 24 Rubella 0 1 2 0 3 25 Cremian-Congo Haemorrhagic Fever 0 0 0 2 2 26 Gas Poisoning 0 1 0 1 2 27 Acute Febrile Illness 1 0 0 0 1 28 Buffalo pox 0 1 0 0 1 29 Epidemic dropsy 0 0 1 0 1 30 Kyasanur Forest Disease 0 0 0 1 1 31 Pertussis 0 0 1 0 1 32 Viral Hepatitis B 0 1 0 0 1 33 Vitamin A Overdosage 0 0 0 1 1 553 799 990 699 3041 Year Sl. No. Disease/Illness Total Total
  • 51. IDSP status of Tripura • SSU and DSU was set up in 2005-2006 • Total DSU is 4 • Total reporting site: 802 • Every week – 630 sub-center, 91 government/ private laboratories and 107 PHC/CHC are reporting in S, P, L format • Training status: Medical officer & doctors 420 MPS 20 MPW 658 Lab technician 90
  • 52. • 3 DSU and SSU is equipped with EDUSAT • SSU is having the facility of video conferencing with CCU • RGM Hospt, North Tripura – identified as District Priority Lab • Contractual Staff position under IDSP as on June, 2012 Designation Number Consultant (Finance) 1 Data entry operator 4
  • 53. Professional Sanctioned post In position Trained Epidemiologist 5 0 0 Microbiologist 2 0 0 Entomologist 1 0 0 Total 8 0 0 Human resource for Tripura
  • 54. IDSP status of Manipur • Manipur is a phase II state under IDSP Human resource for Manipur (till 30 th June 2011) Professional Sanctioned post In position Trained Epidemiologist 10 3 3 Microbiologist 2 0 0 Entomologist 1 0 0 Total 13 3 3
  • 55. • Outbreak and epidemic after introduction of IDSP in Manipur Outbreak Place and time Dengue Moreh in Dec 2007 Scrub Typhus Bishnupur in April 2008 malaria Churachandpur In March 2009 Malaria Moreh in April to July 2009 Malaria Touthong Khunou in June 2009 German measles Khurai, Imphal East in May 2009 Japanese encephalitis June-July 2010
  • 56. • RRT in every district is in position to response to any out break • 7 CMOs and 2 DSOs have been trained on FETP in 2010 • An innovation EWS reporting by using SMS from periphery to district and state surveillance was introduced in the 2011-2012 session • Informer will be given Rs 70 recharge card / month
  • 57. • Sentinel surveillance of the Vaccine preventable childhood infectious disease started in JNIMS in 2010-11 • District priority laboratory at District hospital Churachandpur has been fully equipped and is ready to function • The daily newspaper and e-mail scanning was introduced in the 2011-2012 financial year • SIT equipments installed at State Headquarter, 9 DSUs and Regional Institute of Medical Sciences, Imphal • Manipur has 9 districts. Four out of nine DSUs are reporting weekly data and outbreak report regularly
  • 58.  Total DSU: 11  No. of DSU equipped with EDUSAT- 10 Status: Non-functional  New diseases detected after introduction of IDSP: JE, Dengue, Scrub Typhus, Kala Azar (migrant)  IDSP Priority Lab- 2 IDSP Status in Nagaland
  • 59.  No of RRT : 3  24 X 7 call centre established after detection of swine flu case in Nagaland  Sentinel surveillance – not done  Media scanning cell: 1 national and 3 local newspaper screened everyday  Account in Facebook as Nagaland IDSP opened  DSU reporting: regular but completeness lacking
  • 60. Human Resources for Nagaland Professional Sanctioned post In position Trained Epidemiologist 9 7 7 Microbiologist 3 3 3 Entomologist 1 1 1 Total 13 11 11
  • 61. 1. Training of Trainers (TOT) -15 2. Orientation of District Surveillance Officers (DSOs) done - 11 3. Medical Officers - 92 4. Lab. Tech/ Asst. - 41 5. MPWs - 431 6. Accountants(IDSP) - 11 7. DEOs - 24 8. Sensitization of Private Practitioners/ Paramilitary done for all Districts
  • 62. Training programme for 2012: Field Epidemiological Training Programme(FETP) – target achieved Training of Trainers(TOT) – target achieved Training of MO and Para- medical staffs – not yet done
  • 64. Key Performance Indicators  Number and percentage of districts providing monthly surveillance reports on time – by state and overall  Number and percentage of responses to disease-specific triggers on time - by state and overall  Number and percentage of responses to disease-specific triggers assessed to be adequate -by state and overall  Number and percentage of laboratories providing adequate quality of information – by state and center
  • 65. Contd.  Number of districts in which private providers are contributing to disease information  Number of reports derived from private health care providers  Number of reports derived from private laboratories  Number and percentage of states in which surveillance information relating to various vertical disease control programs have been integrated
  • 66. Contd.  Number and percentage of project districts and states publishing annual surveillance reports within three months of the end of the fiscal year  Publication by CSU of consolidated annual surveillance report (print, electronic, including posting on the websites) within three months of the end of fiscal year
  • 68. • Surveillance units have been established in all states/districts (SSU/DSU) • 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
  • 69. Contd. • On an average, 20-30 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 and 1675 outbreaks in 2011. In 2012, 482 outbreaks have been reported till 29th April • A total of 1758 media alerts were reported from July 2008 to March 2012 • About 2.7 lakh calls have been received from beginning till now, out of which more than thirty five thousand calls were related to Influenza A H1N1 • 50 identified district laboratories are being strengthened for diagnosis of epidemic prone diseases and a network of 12 laboratories has been developed for Influenza surveillance in the country
  • 70. Contd. • In 9 States, a referral lab network has been established • Recruitment of 301 Epidemiologists, 60 Microbiologists and 23 Entomologists has been completed so far
  • 72. • The project was launched throughout the county but on papers and no training of professionals and staff involved in data collection and transmission has been completed • The project started in 2005-06 but functional software was shared during end of 2008, thereby leading to gaps in data entry, data-basing and analysis • Difficulty in ensuring the quality of training in a cascade method • Lack of trained epidemiologist and microbiologist
  • 73. • Trained District Surveillance Officers have not been able to use their skills due to high turnover. In addition, the district surveillance officer has multiple responsibilities • Involvement of Medical Colleges (In the first PIP there was no provision for training, outbreak investigation and contingencies etc. for Medical Colleges) • Funds committed for medical college laboratory to act as State Reference Laboratory were not available.
  • 74. • District Laboratories do not have the infrastructure/manpower with adequate skills for undertaking confirmatory tests for a number of diseases • Broadband connection installation and maintenance of VC was centrally coordinated, as a result of which minor defects could not be rectified locally and Data Managers were not trained enough to rectify the defects • At the time of disaster, SSU and State Health Control Room operate in the same office because of which the routine surveillance gets diluted
  • 75. • Public Health which gets activated only during the time of disaster and crisis is yet to get its due place in day to day functioning of the health system • Lack of monitoring and supervision at all levels • Private sectors and semi-government organization have not been involved in the same proportion as of their numbers • Number of parallel systems under various programs are still operating and duplication of record generation has not gone down
  • 77.  Integrated Disease Surveillance Project (IDSP) is a decentralized, state based surveillance programme in the country  It is intended to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner  It is also expected to provide essential data to monitor progress of on-going disease control programmes and help allocate health resources more efficiently