Objective="Optimum utilisation of the resources by timely collection of data to control epidemic of the diseases."
Details for Reform Option "Integrated Diseases Surveillance Project, Goa."
Integrated Diseases Surveillance Project (IDSP) was started by Government of India to detect early warning signals of any impending outbreaks. Goa was included in the second phase i.e. from 2005.
In order to operationalise the IDSP in Goa, MoU was signed between State of Goa and centre on August 2005. Goa State Surveillance unit and Goa State Surveillance Committee were formed under the chairman ship of the Secretary (Health). State Epidemiologist was appointed as State Surveillance officer as well as member secretary for both the committees. At district level, District collector is the chairperson whereas district surveillance officers are the member secretaries. IDSP cell in Goa became fully operational from 1st April 2006. The reports are received by the District Units from the Primary Health Centres. In order to encourage the peripheral medical officers for timely reporting, INR 1000 is given to them at a time. They are allowed to pay bus fares for the informants and medical officers are asked to keep a record of the payments made in a register. On exhausting the amount, the record is submitted to the District Unit to get a further amount of INR 1000.
This has a dual effect-
1) Though the informants, who are usually the peons or other Class IV staff, are entitled to get TA/DA for their tour, it is a cumbersome process and so they are happy to receive an on-the-spot payment of bus fare.
2) The Medical Officers in charge of the PHC are anyway authorised to make payments of upto INR 1000 without being questioned by any other authority, so they find this sum handy.
Thus in one stroke we achieve two results- The staff is happy to feel important (as they feel that someone has the consideration to pay them in cash for their efforts) and the Medical Officer is also happy that he does not have to request or beg the informant to take the report to the district.
It is seen that this small gesture (incidentally, the amount involved for the whole state is less than INR 10,000 per month, which, when seen as an investment towards preventing many diseases, is very meagre) leads to richer dividends, since the informants feel encouraged and work better in the implementation of other National Health Programmes as well due to the change in their attitude.
Since the weekly reports are received regularly, the needed action is possible to be taken well within the time to show the maximum impact on the outcome. For example, there are many instances where a PHC has reported a little higher number of cases. The Surveillance Unit could alert the respective PHC to this fact and monitor the situation from the District or State to tackle the suspected outbreak in time. Moreover, the fact that the reports are received within a week’s time adds to the effectiveness of the control measures by tackling a disease within its incubation period.
Capital cost incurred in the establishment of the IDSP cell was approximately INR 50 lakhs and recurring cost is about 15 lakhs per annum.
Approximately one year from planning to implementation.
Timely collection of data: The above system of Data Collection helps in the timely collection of data from periphery.
Zone wise analysis: Computerised analysis gives an opportunity to take out zone wise information to take decisions.
Coordination with other programme official: To get coordination with the programme officials for reporting of a particular programme may pose unnecessary problems in smooth functioning.
Frequent transfer: Frequent transfers of the trained staff create a hindrance.
Training to medical officers at PHC.
Computer infrastructure up to the peripheral level
Who needs to be consulted
State Surveillance officer
Good. Instalment of the computers and training of the concerned official to operate it is one time capital cost but system provides cost benefit in terms of efficiency and timely decision for impending outbreak.
Chances of Replication
Timely collection and analysis of data helps in taking rational decision with available resources before a disease become a menace.
Dr. Anuradha Davey, Research Consultant, National Institute of Medical Statistics, ICMR and Ms P.T. Subha, Dy Director, FSU Bangalore, CBHI. Feb, 2007