Integrated Disease Surveillance Programme (IDSP)

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Rationale:

The project development objective is to improve the information available to the government health services, NGO sector, medical colleges and private health care providers on a set of high-priority diseases and risk factors, with a view to improve the on-the-ground responses to such diseases and risk factors.
Specifically, the project aims:

  • To establish a decentralized state based system of surveillance for communicable and non-communicable diseases, so that timely and effective public health actions can be initiated in response to health challenges in the country at the state and national level.
  • To improve the efficiency of the existing surveillance activities of disease control programs and facilitate sharing of relevant information with the health administration, community and other stakeholders so as to detect disease trends over time and evaluate control strategies.
The project will assist the Government of India and the states and territories to:
  • Start/ strengthen surveillance for a limited number of health conditions and risk factors
  • Strengthen data quality, analysis and links to action
  • Improve laboratory support
  • Train stakeholders in disease surveillance and action
  • Decentralize surveillance activities
  • Ensure greater coordination between various sectors
  • Integrate disease surveillance at the state and district levels, and involve communities and other stakeholders.
Integrated Disease Surveillance Program (IDSP) is intended to be the backbone of public health delivery system in the country. It is expected to
  • Provide Essential data to monitor progress of on going disease control programs and help in optimizing the allocation of resources.
  • Be able to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner.
  • Monitor trends of chronic diseases/ risk factors for non-communicable diseases.
  • Prevent potential outbreaks.
  • Facilitate the study of disease patterns in the country and identify emerging and reemerging diseases.
  • Evaluating interventions, for example, vaccination programs.
  • Play a crucial role in obtaining political and public support for the health programs in the country. Surveillance data can be effectively used for the purpose of social mobilization to help the public participate actively in controlling important diseases.
List of Core diseases: A total of 13 diseases both communicable and non-communicable have been included for the surveillance as per the decision of the IDSP committee. These have been grouped as per the types of surveillance into
  • Regular surveillance
  • Sentinel surveillance
  • Regular periodic surveys
 
Objectives
  •  To improve information availability for a set of high priority diseases.
  • To strengthen existing data system on communicable and non-communicable diseases through improved surveillance.
 
Strategies:

Regular Surveillance:
Vector Borne Disease:                1. Malaria (Other vector-borne diseases under  this group)  Like Dengue, JE, Leishmaniasis, Chikungunniya etc.
Water Borne Disease:                2.  Acute Diarrhoeal Disease           
                                                (Cholera)
Respiratory Diseases                 3.Typhoid:                            
                                                 4.Tuberculosis
Vaccine Preventable Diseases: 5.Measles
Diseases under Eradication:      6.Polio
Other Conditions:                   7.Road Traffic Accidents (Link up with Police Computers)
Other International Commitments 8.Plague
Unusual Clinical Syndromes:     9.Menigoencephalitis / Respiratory Distress, Hemorrhagic fevers and other undiagnosed    conditions

Sentinel Surveillance:
Sexually transmitted diseases /
Blood borne:                              10. HIV / HBV, HCV
Other Conditions:                       11. Water Quality
                                                   12. Outdoor Air Quality           (Large Urban Centres)
Regular Periodic Surveys:
NCD Risk Factors:                                 13.Anthropometry,Physical Activity, Blood                     Pressure, Tobacco, Nutrition, Blindness                    
                                 & any            other unusual Health  condition.
GOI may include in a public health emergency – subject to agreement at the next joint project review mission; project funds could be used for these surveillance activities.

State Specific Diseases under Surveillance (Provisional)

The following state specific diseases (provisional) will be kept under surveillance since they are of public health concern for the state of Orissa.

  1. Filariasis
  2. Leprosy
Administrative and technical structure at state level in IDSP:
State Surveillance Committee
A state surveillance committee has been set up under the chairmanship of the Health Secretary to oversee all the surveillance activities in the state and will be administratively responsible for program activities in the state. The chairmanship by the Health Secretary is vital considering that the coordinating role of this committee with other departments during large-scale epidemics is going to be very vital and it was felt that the Health Secretary would be in a better position to do so.
State Surveillance Unit
Joint DHS (PH) is the State Surveillance Officer, State Epidemiologist, Surveillance Medical Officer will assist the State Surveillance Officer. Data Entry is managed by 3 DEOs, One Administrative Asst. and One Helper is in position. State Finance Manager of Orissa State Health & FW Society will manage the work of Consultant Finance. Consultant Training will be recruited soon.
The function of the State Surveillance unit
  • Collation and analysis of data received from districts and transmitting to Central Surveillance Unit.
  • Coordinating activities of rapid response teams and deputing them to the field.
  • Monitoring and reviewing the activities of the district surveillance units including checks on validity of data, responsiveness and functioning of the laboratories.
  • Coordinating the activities of the state public health laboratories, medical colleges and other state level institutions.
  • Sending regular feedback to the district units on the trend analysis of data.
  • Coordinating all training activities under the project.
  • Organizing meeting of the State surveillance committee.

District Surveillance Committee
The district surveillance committee will be responsible for the regular running of the program at the district level. The district surveillance committee will be chaired by the District Collector / District -Magistrate.
District Surveillance Unit
Asst. District Medical Officer (Public Health) is the District Surveillance Officer. Data Entry is done by the existing DEOs dealing with disease surveillance activities. Administrative Asst. and Account Asst. has been reallocated within the existing staffs.
The functions of the district surveillance unit

  • Collation and analysis of data received from districts and transmitting to State Surveillance Unit.
  • To Constitute rapid response teams and deputing them to the field whenever needed.
  • Implementing and Monitoring all project activities.
  • Coordinating with public health laboratories, medical colleges, NGOs and private sectors.
  • Sending regular feedback to the reporting units on analysis of data.
  • Coordinating training and IEC activities within the district.
  • Organizing meetings of the district surveillance committee
Activities:

Project Activities

  • Upgradation of Laboratories
  • Information Technology and Communication
  • Human Resources and Development
  • Operational Activities and Response
  • Monitoring and Evaluation
  • Funds released on the basis of National PIP where in 30 District HQ Hospitals and 157 CHCs have taken into consideration.
  • The State PIP duly projected 314 Block PHC / CHCs. The funds provided to the State under different components like Training, Operational Cost IEC activities, etc. are in adequate.
  • Central Surveillance Unit vide their Letter No. T.18015/27/2004-IDSP Dt. 25/09/06 allowed the States to incur the expenditure under various components as per the approved guidelines and utilize the funds available with them irrespective of the component wise allocation.
  • State Surveillance Unit, Orissa has given a proposal for reallocation of funds for training component to Central Surveillance Unit and utilize the funds available with the State within October 2006 to March 2007.

Activities

  • Civil Works: - Civil works of the District surveillance Unit and State Surveillance Unit an amount of Rs. 43,40,000/- released. For District Public Health Lab and State Public Health Lab an amount of Rs. 43,40,000/- released. (Total – Rs. 86,80,000/-)
  • Furniture and Fixtures: - An amount of Rs. 18,60,000/- has been released to the District surveillance Unit and State Surveillance Unit for furniture and fixtures. For District Public Health Lab and State Public Health Lab an amount of Rs. 18,60,000/- released. (Total – Rs. 37,20,000/-)
  • Operational Cost: - In the operational cost component, an amount of Rs. 6,28,000/- has been released to the Peripheral Surveillance Unit and Rs. 7,50,000/- released to the District Surveillance Unit and Rs. 1,22,000/- for State Surveillance Unit released. (Total -  Rs. 15,00,000/-)
  • IEC Activities: - An amount of Rs. 15,00,000/- has been released to the State Surveillance Unit for printing of Oriya Manual for Health Workers, Printing of Reporting Formats & Registers for IDSP.

Training

  • At the State level, training of District & State Surveillance team members has been completed by National Institute of Epidemiology, Chennai.
  • Out of project 125 members, 119 have been trained till December 2006.
  • For training of other categories
    • Medical Officers
    • Health Worker (M&F) & Health Supervisors (M&F) and Pharmacists
    • Laboratory Technician
    • Data Entry Operators
  • An amount of Rs. 1,13,25,758/- has been worked out keeping the duration of training constant and reducing financial norms on per diem, refreshment, travel, contingency etc. As the amount exceeds the amount projected in the National PIP, Central Surveillance Unit is being requested to approve the same to conduct all categories of training within the month of March 2007.

Laboratory Equipment & Consumables

      • Laboratory assessment of district laboratory in relation to space, equipments, personnel and test undertaken is underway.
      • After lab assessment, central surveillance unit will provide major lab equipments and other minor lab equipments & consumables will be procured locally in consultation with the other disease control programme like Malaria, TB etc.

Office Equipments

  • The State is allowed to procure telephones and air conditioners initially and other equipments like Photocopiers, OHP, Fax, LCD Projectors etc were to be procured centrally and supplied to the States. But now Central Surveillance Unit has intimated that all the office equipments and lab equipments like auto clave and hot air oven, UPS etc. have been decentralized and will be procured by the State.

Personnel

  • Existing Staff of State Disease Surveillance Cell redeployed under IDSP and will be paid remuneration from October 2006 onwards from IDSP. At the District Surveillance Unit, the Administrative Asst. and the Account Asst. have been identified from within the existing staff and will be provided incentives.