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Unit-IV Health Surveillance ANP I year.pptx

  1. Dr.Anjalatchi Muthukumaran Vice Principal Era college of Nursing Unit-IV Epidemiology Health Surveillance
  2. Content of the chapter  Introduction  Definition  Nursing surveillance  Health surveillance  Surveillance in india  Vision 2035  importance of surveillance  Goal of public health surveillance  Type of surveillance  Surveillance process  Summary  Conclusion  References
  3. INTRODUCTION  In the everyday life of hustle and bustle, it is almost a lacking hour to keep a watch on health. As being noted by many great leaders and personalities around us “health is life”. We must keep an eye to look for it. As it is a need of the hour to keep our health maintained and to keep a keen watch over it. Thus emphasizing its “SURVEILLANCE”.  “It is health that is real wealth and not pieces of gold and silver.” – Mahatma Gandhi
  4. Vision 2035 - Public Health Surveillance in India  Introduction  Surveillance is an important Public Health function. It is an essential action for disease detection, prevention, and control. Surveillance is ‘Information for Action’.  ‘Vision 2035: Public Health Surveillance in India’ is a continuation of the work on health systems strengthening. It contributes by suggesting mainstreaming of surveillance by making individual electronic health records the basis for surveillance. Public health surveillance (PHS) is an important function that cuts across primary, secondary, and tertiary levels of care.  The vision document is a step in that direction, it articulates the vision and highlights the building blocks. It envisions a citizen- friendly public health system, which will involve stakeholders at all levels, be it individual, community, health care facilities or laboratories, all while protecting the individual’s privacy and confidentiality.
  5. Definition  1963-The French defined surveillance in three words, ‘to watch over’ .  1968-Langmuir defined surveillance as ‘the continued watchfulness over distribution and trends of incidence through systematic collection, consolidation, and evaluation of morbidity and mortality reports and other relevant data
  6. Definition continued  The Centre for Disease Control, Atlanta, US defined surveillance as ‘the ongoing systematic collection, collation, analysis and interpretation of data and dissemination of information to those who need it, in order that action is taken.”
  7. Vision  To make India’s public health surveillance system more responsive and predictive to enhance preparedness for action at all levels.  Citizen-friendly public health surveillance system will ensure individual privacy and confidentiality, enabled with a client feedback mechanism.  Improved data-sharing mechanism between Centre and states for better disease detection, prevention, and control.  India aims to provide regional and global leadership in managing events that constitute a public health emergency of international concern.
  8. In 2035,  India’s Public Health Surveillance will be a predictive, responsive, integrated, and tiered system of disease and health surveillance that is inclusive of prioritized, emerging, and re-emerging communicable and non- communicable diseases and conditions.  Surveillance will be primarily based on de-identified (anonymised) individual-level patient information that emanates from health care facilities, laboratories, and other sources.  Public Health Surveillance will be governed by an adequately resourced effective administrative and technical structure and will ensure that it serves the public good.  India will provide regional and global leadership in managing events that constitute a Public Health Emergency of International Concern.
  9. What is surveillance in nursing?  The definition of surveillance proposed by the Nursing Intervention Classification is the purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making.
  10. What is health surveillance?  Health surveillance is a scheme of repeated health checks which are used to identify ill health caused by work. Health and safety law requires health surveillance when your workers remain exposed to health risks even after you have put controls in place.
  11. DEFINITION  Surveillance is a systematic process of collection, transmission, analysis and feedback of public health data for decision making.  ▫ The surveillance means supervision or close watch especially on suspected person. Epidemiologically surveillance means close vigilance on occurrence and distribution of diseases, health related problems, population of dynamics, community behavior as well as environmental processes resulting in increased risk of ill health in the community
  12. WHY IS IT IMPORTANT TO SURVEILLANCE THE HEALTH ?  ▫ It serves as an early warning system for impending public health emergencies.  ▫ It document the impact of an intervention, or track progress towards specified goals  ▫ Monitor and clarify the epidemiology of health problems, to allow priorities to be set and to inform public health policy and strategies.
  13. What could be the goals of Public Health Surveillance  Predicting/Forecasting and Preparedness for Epidemic Outbreaks for communicable and emerging epidemics of non-communicable disease, both re- emergence of known illnesses in different forms (influenza, MDR-TB), or new disease outbreaks (NIPA virus, Corona virus, etc.,) or new geographic foci of NCD.  • Guiding Prevention and Health Promotion Strategies: Identify new/hidden reservoirs and sources of infection, block chains of rapid transmission and limit the resulting morbidity, disability or death.  • Responding to Outbreaks and Guiding Future Programs of Disease control: Institute standard protocols of a) characterising results beginning with molecular tests, b) digitise results and ultimate action in real-time, c) conduct genetic mapping to explore variations in the pathogen or the susceptible host.
  15. Continued  INDIVIDUAL OR FAMILY SURVEILLANCE It includes surveillance of an infected person in a family as long as the individual is the source of infection to others . e.g. typhoid case and carriers  COMMUNITY OR LOCAL POPULATION SURVEILLANCE ▫ It includes surveillance of the whole community for early detection and prevention & control of a disease e.g. malaria  NATIONAL SURVEILLANCE ▫ It includes surveillance at the National level e.g surveillance of small pox after its eradication.  INTERNATIONAL SURVEILLANCE ▫ It includes surveillance of some of the diseases which are listed by WHO e.g malaria, influenza etc. are to be reported information to the countries in the world to take timely actions.
  16. EPIDEMIOLO GICAL SURVEILLANCE  ▫ In many countries where particular diseases are endemic special control eradication programmes have been instituted. For example, National Disease Control Programmes against malaria, tuberculosis, leprosy etc. These programmes have yielded considerable morbidity and mortality data for the specific diseases
  17. SURVEILLANCE PROCESS 1• Collection of relevant information about the disease under surveillance 2 • Compilation and analysis of data 3 • Reporting of data and providing feedback
  18. Gap areas identified in India’s Public Health Surveillance  The document identifies gap areas in India’s Public Health Surveillance that could be addressed.  India can create a skilled and strong health workforce dedicated to surveillance activities.  Non-communicable disease, reproductive and child health, occupational and environmental health and injury could be integrated into public health surveillance.  Morbidity data from health information systems could be merged with mortality data from vital statistics registration.  An amalgamation of plant, animal, and environmental surveillance in a One-Health approach that also includes surveillance for anti-microbial resistance and predictive capability for pandemics is an element suggested within this vision document. 
  19.  Public Health Surveillance could be integrated within India’s three-tiered health system.  Citizen-centric and community-based surveillance, and use of point of care devices and self-care diagnostics could be enhanced.  Laboratory capacity could be strengthened with new diagnostic technologies including molecular diagnostics, genotyping, and phenotyping. To establish linkages across the three-tiered health system, referral networks could be expanded for diagnoses and care.
  20. Building blocks envisages for the vision  The building blocks for this vision are an interdependent federated system of governance between the Centre and states, a new data- sharing mechanism that involves the use of new analytics, health informatics, and data science including innovative ways of disseminating ‘information for action’.
  21. Four building blocks are envisaged for this vision:  An interdependent federated system of Governance Architecture between the Centre and States,  Enhanced use of new data collection and sharing mechanisms for surveillance based on unitized, citizen-centric comprehensive Electronic Health Records (EHR) with a unique health identifier (UHID). As well, existing disease surveillance data and information from periodic surveys will complement this information  Enhanced use of new data analytics, data science, artificial intelligence, and machine learning, and  Advanced health informatics.
  22. Suggested Steps to move forward  Establish a governance framework that is inclusive of political, policy, technical, and managerial leadership at the national and state level.  Identify broad disease categories that will be included under Public Health Surveillance.  Enhance surveillance of non-communicable diseases and conditions in a step-wise manner.  Prioritize diseases that can be targeted for elimination as a public health problem, regularly.
  23.  Improve core support functions, core functions, and system attributes for surveillance at all levels; national, state, district, and block.  Establish mechanisms to streamline data sharing, capture, analysis, and dissemination for action. These could include the use of situation-aware real-time signals from social media, mobile sensor networks, and participatory surveillance systems for eventbased epidemic intelligence.  Encourage innovations at every step-in surveillance activity.
  24. References  The full document can be accessed at 12/PHS_13_dec_web.pdf  Source : NITI Aayog