Health Policy Issues and Health Programmes in ... - Amazon S3

Designing a Surveillance SystemOnce priorities for surveillance are developed, a plan of action is needed. There is a system ofreporting from the primary health centre to the district, state, national, and international levels.At all levels, it is critical to specify individual responsibilities. This must include thoseresponsible for data collection, reporting, and analysis as well as feedback action at all levels.This is a key component for a surveillance plan. Finally, the infrastructure needs are critical indeveloping a plan. Several different areas will need to be addressed, including the level ofpersonnel required. Some existing personnel are already collecting data for various nationalprogrammes; can or should their duties be expanded? What additional personnel are neededand where? Next, what are the laboratory requirements for conditions in the surveillanceprogramme and do existing facilities need to be strengthened or new facilities developed. So,where should they be located? Some conditions for which strong laboratories are necessaryinclude tuberculosis and malaria. Another important area to be considered is communications.What sort of communications network will be needed? It is exciting to hear that Uttaranchal isalready planning for a communications network. How can it be used or integrated with thesurveillance programme?Training is another key component of a surveillance programme. Once responsibilities areassigned, then it is important to determine whether the team members have skills to carry outwhat is required. What are the training needs for the personnel? How is it going to be provided?Do the facilities exist and, if not, what will be required to develop the programme? Here it isimportant to consider training needs for all levels of personnel from individuals collectinginformation to those responsible for analysing and acting on the information that is obtained.How are you going to provide quality control? In the United States, there is a saying—“garbage in,garbage out”. You can have a lot of information but if it is not valid or accurate, the plans oractions that are based on that information might be totally useless. So, it is important to ensurethe quality of information that you have.Another important consideration is to determine the available resources for the programme,locally, nationally, or internationally. The National Institute of Communicable Diseases is amajor resource in this country, and there are many other resources in the state as well as thecountry. An important resource to consider is the private sector. For surveillance, this is crucial aswe find that many people don’t go to the public sector; therefore, public–private partnershipsmay be critical for a successful surveillance system. In addition to public–private partnerships,and linking district, state, and national systems with key reference centres, it is important toprovide access to expertise when needed.56Inter-sectoral coordination is important for a successful surveillance programme. It isinteresting to note that committees have already been formed and some of the key programmestalked about include the reproductive and child health programmes as well as education.Tourism has also been discussed. Finally, it is important to look at how the programme will befunded. The level of resources required will depend on the system that is being planned and thelevel of existing resources. This has already been discussed as potential resources for the stateincluding the upcoming proposal by the Government of India to The World Bank for