Review Meeting with State Health Secretaries on 11 th & 12 th September, Integrated Disease Surveillance Programme (IDSP)

Integrated Disease Surveillance Project (IDSP) – (1) IDSP will continue during 12 th Plan as Integrated Disease Surveillance Programme (IDSP) under NRHM –All Reporting Units in districts to report through portal –Analysis and use of data and feedback at all levels –District public health labs under IDSP –All States need to report outbreak every week –Recording of diagnosis by doctors in OPD register in major hospitals –Private sector participation in reporting of data

–Need for increased monitoring and supervision by State Secretary/MD (NRHM)/DHS –Strong coordination between DHS and DME –Dedicated SSOs and DSOs for IDSP –Recruitment of all contractual manpower –Involvement of medical colleges (Data reporting, Training, lab support, members of RRT Integrated Disease Surveillance Project (IDSP) – (2)

Integrated Disease Surveillance Programme Central Sector Scheme under umbrella of National Rural Health Mission (NRHM) Objective: Strengthening of Disease Surveillance System for epidemic prone diseases to detect and respond to outbreaks Launched with World Bank assistance in Nov 2004; restructured and extended upto March 2012 World Bank funds during for Central Surveillance Unit (CSU) and 9 identified States (Andhra Pradesh, Gujarat, Karnataka, Maharashtra, Punjab, Rajasthan, Tamil Nadu, Uttarakhand and West Bengal), domestic funds for 26 States/UTs Proposed to continue during 12 th Plan as Integrated Disease Surveillance Programme (IDSP) with domestic budgetary support

How the System functions? All DSUs, SSUs and CSU connected by IT network DSU collects weekly data on epidemic prone diseases from health facilities, compile and analyze to detect rise in cases Weekly data are shared with SSU and CSU through e- mail and portal ( Increase in cases/outbreaks are investigated and responded to by district/state/central Rapid Response Teams (RRTs) SSOs, DSOs, RRTs have been trained by CSU at identified apex institutes

Summary of Current Status and Way Forward (1) Current StatusFurther Actions Needed Surveillance Units established in all states/districts SSO and DSO should be dedicated or primarily for IDSP IDSP should be frequently and regularly monitored by State Secretary/MD, NRHM, DHS Involve Medical colleges fully 301/646 Epidemiologists, 61/85 Microbiologists, 22/35 Entomologists recruited by States Need to expedite recruitment of all positions; recruitment already decentralized Training of Rapid Response Teams completed for all States/UTs States may give list of additional officers to be trained to CSU IT equipment installed at 776/800 sites AMC of NIC-IT equipment decentralized Broadband connectivity decentralized Use of IT network at state/district levels AMC at state level to be done Need to fill-up master data in portal

Summary of Current Status and Way Forward (2) Current StatusFurther Actions Needed 35/50 identified district public health labs functional Referral lab network functional in 9 states Need to make all 50 labs functional Strengthen more labs under NRHM Referral lab network to be strengthened in 8 more states in >90 % of the districts report weekly surveillance data through portal All Reporting Units in all districts to report through portal Data to be analyzed and used at all levels Weekly data collected from primary health care units and usually only IPD data collected from major hospitals Doctors write diagnosis in OPD register Need to collect OPD data from major hospitals, medical college hospitals Outbreaks reported by States/UTs 553 in 2008 (lab confirmed 132; 24%) 799 in 2009 (lab confirmed 137; 17%) 990 in 2010 (lab confirmed (153; 16%) 1675 in 2011 (355; Lab confirmed 21%) 1067 in 2012 (upto 19 August) All states need to report outbreaks every week; Even “Nil” reporting is mandatory Samples in all outbreaks should be sent to labs for diagnosis To prepare complete outbreak investigation reports

Weekly EWS/Outbreak report submitting Status of States/UTs in 2012 EWS/OUTBREAK REPORT SUBMITTING STATUS STATES / UTs > 80% times reportedAll states except given below % times reportedGoa, Uttarakhand, Nagaland, Dadar and Nagar Haveli, Puducherry, Chhattisgarh, Mizoram % times reportedA& N, Chandigarh < 25 % times reportedManipur, Delhi Never reportedLakshadweep “Nil” reporting is considered as report submitted