Dr. Prem Lal
Hon'ble CMO
Haridwar, Uttarakhand.
IDSP Links
IDSP (Integrated Disease Surveillance Programe)
The Government of India is initiating a decentralized, state based Integrated Disease Surveillance Project (IDSP) 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 out Breaks and help and initiate an effective response in a timely manner. It is also expected to provide essential data to monitor progress of on going disease control programs and help allocate health Resources more optimally. Current advanced to technology is to be used for collecting data for different diseases. It is proposed to provide network connectivity initially up to District level. Computers for data entry and Receiving inputs from the district level would be available.

State has successfully developed web based weekly surveillance system capable of forecasting an epidemic. Analysis of weekly surveillance data on regular basis, providing feedback to reporting units and early actions by reporting units has lead containment of diseases ultimately reducing mortality and morbidity. Before the IDSP was established, the disease surveillance data was being collected on monthly basis thus, there was no system of ongoing surveillance in the state and because of that the system of early warning signal was no existing.

One of the important components of the Project is to use Information Technology and Communication Technology in data management, analysis and rapid response in case of impending outbreaks. To strengthen transmission of data, the Ministry of Health & FW and Indian Space Research organization (ISRO) have agreed to cooperate in providing satellite linkage for various activities under World Bank funded Integrated Disease Surveillance Project. ISRO would provide adequate bandwidth on one of its satellite, EDUSAT for this Project. This satellite has 5 regional beams and one national beam covering the entire country.

Vision
  • To establish State based a comprehensive surveillance information system covering public and private sector (Active surveillance by paramedical staff of rural and Urban and passive surveillance by Govt. And private hospitals and laboratories)
  • Build capacities to analyze and use surveillance information at all levels to identify communicable disease outbreaks early.
  • Ensure that all outbreaks will have high quality investigation by multi-specialty rapid response team supported by laboratory confirmation.
  • Deployment of epidemiologist at all 13 districts.
  • Ensure functional IT systems & on-line data entry and analysis.
  • District supported by a well performing laboratory with EQAS and State Referral Laboratory Network.
  • Training of Municipal Corporation staff to strengthen Urban Surveillance.
  • Training of BHOs and M & E for data analysis.

Objectives
  • To integrate and decentralize surveillance activities.
  • To establish systems for data collection, reporting, analysis and feedback using information technology.
  • To improve laboratory support for diseasesurveillance.
  • To develop Human resources for disease surveillance and action.
  • To involve all stakeholders including private sector and communities in surveillance.

Under this programme a weekly web-based reporting system has been established in 13 districts. 11156 reporting units (Table : 1) from these 13 districts of 22 communicable disease (including neonatal tetanus as a state specific disease) to the State Surveillance Unit.

The data flow is electronic from the district level onwards (Dataflow chart). The IDSP software is functional through GOI www.idsp.nic.in External website that opens in a new window which data from the districts, Medical Collages and Municipal Corporation are available for the analysis and early detection of out breaks.

Strategies
  • Decentralisation : Currently, the process of data entry is being performed only at district and state level; however, in near future the facility could be extend to the block level to make the process of surveillance more accurate and simple.
  • Co-ordination : All the relevant agencies should have health coordination to make the process of surveillance and outbreak investigation more accurate.
  • Capacity building of the staff : Ongoing training and education is necessary to improve the quality of task performed by public health staff.
  • Rapid Response Teams at District & Peripheral Level : Ideal RRT should be formed and active throughout the district to improve the quality of outbreak investigation along with preventing and controlling measures.
  • Integration of all activities from grass root level (sub centre) up to the state is most important. Integration of private and public health care agencies, integration of all health programs with IDSP, integration of both communicable and non communicable diseases, integration of both rural and urban health system and lastly integration of both private and public medical colleges.
  • Strengthening Labs : Recently the referral lab network plan has been implemented in State in July 2010.
  • Strong connectivity through use of IT.
  • IDSP using broadband, VSet, Tollfree No. 1075 and EDUSET for fast communication.

Integration
To integrate and decentralize surveillance activities.
Integration of the various vertical programms information flow into a single channel, currently, the same staffs are reporting communicable diseases like Malaria, TB, JE, Diarrhea, Hepatitis, Typhoid,Measles,Diphtheria,Neonatal Tetanus etc. in all different formats. By integrating the flow of information, duplication can be minimized and workload can be reduced. Integration of data from Public sector as well as private sector gives true picture of disease pattern in community.

Rapid Response
System of three tier Rapid Response is in place to respond to any outbreak or unusual syndrome Local Level : In case of local outbreak District Rapid Response Team responds in real time, investigate the outbreak & take all preventive measures. Physician / Paediatrician, Epidemiologist/DMO, Pathologist / Microbiologist are the members of DRRT. Regional Level : If outbreak is of serious nature, RRT from Regional Medical College will assist District Response Team to control the epidemic State Level : In case of Major epidemic situation, State RRT responds immediately. This includes, Representatives from Department of : Preventive & Social Medicine, Medicine, Paediatric, & Pathology departments In all the 13 Districts RRT is in place. RRT Members are identified & Trained.

State Referral Network Laboratory Plan
To improve laboratory support for disease surveillance
Integrated Disease Surveillance Project in Haridwar plans to strengthen the public Health Laboratories in the state at various levels in phased manner to provide diagnostic facilities for epidemic prone diseases. In the first phase, referral lab network has developed in 8 medical colleges and priority district reference laboratories at District Hospital Haridwar. All the Head of Department were participated in capacity development workshop conducted by CSU.