Programmes

IDSP (Integrated Disease Surveillance Project)

During Plague outbreak in 1994, with huge morbidity and mortality, the country sustained huge economic losses. Disease Surveillance observed to have deficiencies, which was not able to detect early warning and response was also not as per requirement to reduce the magnitude of the of out break.Pluge out break had shown the need to establish a dedicated disease surveillance system that has been also recommended by high power committee. Having recognized the crucial importance of disease surveillance for improving the health of our people, the Government of India constituted a National Apical Advisory Committee for National Disease surveillance and Response System. The Govt. of India has launched National Surveillance Program for Communicable Diseases (NSPCD) during 1997-98.1997 - National Surveillance Programme for Communicable Diseases (NSPCD) piloted and Gujarat State also involved in this pilot project.

The disease surveillance system which was initiated in Kutch district after the earthquake (2001) was later expanded to cover entire state by the help of GOG and EC. Government of India launched Integrated Diseases Surveillance Project on 8th November 2005. The Gujarat State is front runner in implementation of IDSP. 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.

The mortality and morbidity due to communicable diseases have drastically reduced in Gujarat state over last few years. This is evident from the weekly surveillance data collected, compiled and analyzed under Integrated Disease Surveillance Project implemented in the state since year 2005.

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 26 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 26 districts. 11156 reporting units (Table : 1) from these 26 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.

Details of Weekly Reports

Sr.No. District Number of Reporting Unit (in P - form) Number of Reporting Unit (in L - form) Number of Reporting Unit (in S - form) Total
1 Ahmedabad 134 128 240 502
2 Amreli 54 52 247 353
3 Anand 67 65 278 410
4 Banaskantha 108 108 424 640
5 Bharuch 49 49 200 298
6 Bhavnagar 107 97 324 528
7 Dahod 109 79 332 520
8 Dang 12 11 47 70
9 Gandhinagar 60 47 163 270
10 Jamnagar 74 47 265 386
11 Junagadh 108 86 390 584
12 Kachchh 131 57 278 466
13 Kheda 69 74 317 460
14 Mehsana 84 70 288 442
15 Narmada 31 29 135 195
16 Navsari 64 55 281 400
17 Panchamahal 87 92 399 578
18 Patan 51 47 210 308
19 Porbandar 18 16 84 116
20 Rajkot 97 88 330 515
21 Sabarkantha 91 93 413 597
22 Surat 120 115 385 620
23 Surendranagar 58 51 200 309
24 Tapi 39 36 223 298
25 Vadodara 135 130 576 841
26 Valsad 62 55 330 447
Total 2019 1778 7359 11156

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.

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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 26 Districts RRT is in place. RRT Members are identified & Trained.
View RRT MembersExternal website that opens in a new window

State Referral Network Laboratory Plan

To improve laboratory support for disease surveillance

Integrated Disease Surveillance Project in Gujarat 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 two priority district reference laboratories at District Hospital Mahesana and Sabarkanthha. Strengthening of these Priority district reference laboratories, Microbiologists are appointed on contract basis for these two laboratories. All the Head of Department were participated in capacity development workshop conducted by CSU.

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