Disease Surveillance
The disease surveillance training and health system emergency response component under project Building systems capacity on Outbreaks, Laboratory Surveillance Training Emergency response and Infection Prevention Control and Anti-Microbial Resistance(BOLSTER) supported by the Centers for Disease Control and Prevention (CDC) is working towards improving health systems and strengthening disease detection, diagnostics and mortality surveillance along with epidemiological and public health workforce capacity development. The technical assistance envisaged in the project will help in achieving timely generation of disease burden data, trends and associated risk factors through a robust dovetailed surveillance system which is based on real time data reporting and will enable the system to efficiently manage disease outbreaks and build capacity for public health system resilience over time.
The NITI Aayog's “Vision 2035 for Public Health Surveillance in India” envisages that surveillance in India will need to graduate from traditional data entry systems based on vertical program implementation to real-time data capture from existing health records which are integrated. The project is based on a three-stage process (3 years duration) of health intervention model suggested in selected states of India:
1. To conduct baseline assessment of existing health systems (4-6 months)
2. Capacity building to enhance systems capacity of monitoring and response to common pathogens and emerging outbreaks (1-2 years)
3. Outcome Evaluation and documentation of success and lessons learnt (4-6 months)
The activities envisaged under the Surveillance project are in congruence with the public health surveillance goals stated in NITI AAYOG's-Vision 2035 document. The focus is on strengthening the public health surveillance for improving outbreak preparedness for communicable diseases and also emerging epidemics of non-communicable diseases. While guiding prevention and health promotion strategies, these activities would help build the capacity of public health personnel and improve outbreak response so that the states in India are able to undertake evidence-based decisions and thereby limit the morbidity, disability or death due to outbreak prone diseases.
Baseline assessment of infectious disease surveillance systems including disease monitoring programs in selected states. The outbreak preparedness of these States for epidemic-prone diseases and gaps in existing health systems and District Public Health Laboratory (DPHL) diagnostic capacity will be assessed.
Capacity building of laboratory and public health work force by:
Use of surveillance data for evidence-based decision making: The timely generation of disease burden data, trends and associated risk factors based on real-time data will enable the system to efficiently manage disease outbreaks and build capacity for public health system resilience over time. This will empower decision makers to lead and manage more effectively by utilizing information in a timely manner.
Evaluate Interventions and document achievements: This activity will facilitate the flow of information and support the continuity, quality and safety of data.
Assessment of existing mortality surveillance systems and provide training for all cause-mortality reporting in the selected states: Identification of gaps in the mortality reporting at different levels of the reporting units in the health system and need based interventions will be undertaken to minimize the human/technical reporting errors. Support will be provided to increase reporting of cause of death for all registered deaths in selected states. Training of physicians will be conducted in correct certification of cause of death for all-cause mortality.
Provide training for MIS-C reporting: MIS-C is considered a serious complication of COVID-19 and warrants the need for systematic collection of information to monitor characteristics of the disease and informs public health response.
Provide training for one health disease surveillance: To scale up Anti-Microbial Resistance, Zoonosis (One health) activity and data reporting.
The Kumbh Mela response activities included: