Integrated Disease Surveillance Project -IDSP

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Integrated Disease Surveillance Project (IDSP) Uttarakhand (Phase I)

IDSP Background:
The Government of India is initiating a decentralized State based Integrated Disease Surveillance Project in the country in response to a long felt need expressed by various expert committees. The project would be able to detect early warning signals of impending Outbreak 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 programme and help allocate health resources more optimally. In Uttarakhand the Integrated Disease Surveillance Project was launched on 5th July 2005 with World Bank Assistance.

Objectives:

• To establish a decentralized State based Surveillance system for communicable and non communicable diseases in the State, so that timely and effective public health action can be initiated in response to health challenges for communicable and non communicable diseases.
• To improve the efficiency of the existing Surveillance activities of the disease control programme and facilitate sharing of relevant information with health administrations, community and other stakeholders so as to detect disease trends overtime & evaluate control strategies.

Duration: 2004-2010 – Completed.
: 2010-2012 – Restructuring & Extension.

Restructuring & Extension of IDSP
(2010-2012)

Major Objective:
– Early detection & response to disease outbreaks.

Major components:
Integration and Decentralization of Surveillance activities

Strengthening of Public Health Laboratories

Human Resource Development - Training of SSO, DSO, RRT, other medical and paramedical staff

Use of Information Technology for collection, collation, compilation, analysis & dissemination of data

Integration:
Sharing of surveillance information of disease control programmes
Developing effective partnership with health and non health sectors in surveillance
Including communicable and non communicable diseases in the surveillance system
Working with the private sector and non governmental organization
Bringing academic institutions and medical colleges into disease surveillance

Restructuring of IDSP
1. Establish a comprehensive Surveillance information system covering all the public and private hospital. IDSP will support public health Laboratory with the help of Epidemiologist, positioning of Epidemiologist at State Level and one each at district Level for ensuring on line data entry and analysis.
2. Built capacity to analysis and use Surveillance at all Level to identify communicable disease outbreak early.
3. Ensure that all Outbreaks will have investigation by Rapid Response Team supported by Laboratory confirmation.

The project is operational as follows
1. State and District surveillance units have been established and functioning.

2. District surveillance officers are in placed and looking after the project as an additional responsibility.

3. Three Contractual staff at district level has been appointed The Data Manager been appointed through IAP under NIC/NICSI.

4. EDUSAT equipments have been installed and functioning in 12 districts and 1 medical college in Haldwani.
 
5. Computers at each DSUs, Software & internet services are being used.

6. State and District public health laboratories had been made functional.

7. Two Priority Labs had been setup in Almora and Pauri Garhwal.

8. Private Sector involvements in reporting disease information ton.

9. Weekly ‘S’ ‘P’ and ‘L ’reports are received from reporting units. Analysis done by districts and state unit, feed back given and early warning signals(EWS) are generated, epidemics are detected and attended and investigation are being undertaken.

Surveillance Preparedness

1. This will include positioning of Epidemiologist and making IT system fully functional to ensure on Line data entry and analysis.

2. Each district will be supported by public health Laboratory either at district public health Laboratory meeting the external quality assurance standards (equas) of IDSP to facilitate this IDSP will support a public health Laboratory network.

Outbreak investigation and response

1. An effort will be made for all the Outbreak/rumour reported to be verified within 48 hours of reporting.

2. All effort will be made to collect adequate Laboratory sample from every Outbreak reported.

3. The district RRT will be put into action for all Outbreaks to confirm the diagnosis and ensure management.

4. For documentation of Epidemiological investigation will be maintained and communicated to CSU, SSU.

5. All the medical college Staff, faculty from department of community medicine, Microbiology, general medicine and pediatrician will be exposed to field epidemiology training.

6. Training service SOS reporting and analysis of weekly report.

Analysis and use of Data

1. At the PHC/CHC Level simple analysis of Syndromic Surveillance and Data analysis of Fever, Diarrhea, and Jaundice cases will be carried using printed charts and graphs.

2. All medical Officers will be trained in IDSP, data analysis and as the computer and internet become available at the district Level data entry will also become decentralized.

3. Feedback will be provided to PHC medical officers during monthly meeting. 

Laboratory Strengthening
• To increase the number of OPD sample and a mechanism should be developed for the transportation of specimen of the DPHL or identified reference Laboratory.

• The microbiologist will be more responsible and taking active part in RRT and finally start identifying small epidemic/ pseudo epidemic by comparing trends with previous year.

Goals for Laboratory Strengthening
• Early detection of epidemic prone disease to minimize the impact of Outbreak.

• All districts should have access to etiological for confirmation of Outbreak through existing functional Laboratory.

Referral Laboratory Network Plan
The linkages of the various districts with the proposed referral labs

Microbiology Referral Lab

Linked Districts

Himalayan Institute of Medical Sciences, Jolly Grant

Dehradun, Uttarkashi, Haridwar, Tehri Garhwal

UFHT Medical College, Haldwani

Champawat, Pithoragarh, Nainital, Bageshwar, Udham Singh Nagar

VCSGGMSRI, Garhwal

Chamoli, Rudraprayag

District Priority lab, Pauri

Pauri Garhwal

District Priority Lab, Almora

Almora