World Health Organization
Representative to India
|
|
World Health Organization Representative to India |
|
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Disease and Nutrition Surveillance In Bikaner, Barmer, Jaisalmer and Jodhpur Districts of Rajasthan
Background:
Disease outbreaks often take the form of epidemic causing morbidity and mortality. Scarce resources are often wasted in control measures after the outbreak has already peaked, and the outcome of such measures in limiting the spread of disease outbreak and in reducing the number of cases and deaths is negligible. There are evidences that vaccine related diseases and communicable diseases are preventable and if treated early, can contribute to significant decrease in morbidity and mortality among children, adults, mothers and community at large. It has been realized that there should be an effective surveillance system which can provide epidemiological data for programme interventions, highlight the magnitude of illness, identify the high risk pockets, and provide early warning for outbreaks.
The project was initiated in the four western districts of Rajasthan with a view that the surveillance data would provide a scientific and accurate information for appropriate disease control measures as well as evaluation of public health efforts and allocation of resources. This project strived to develop and operationalize a Disease and Nutrition Surveillance System in the draught affected districts (Jaisalmer, Jodhpur, Barmer and Bikaner) in order to facilitate a suitable rapid early warning and intervention system.
The project was implemented by Indian Institute of Health Management Research, Jaipur in close coordination with the district health system and women and child development department. The project was funded by ECHO South Asia- European Commission, New Delhi and technically supported by WHO, India Country Office.
Objective:
The main objective of the project was to develop and strengthen an organizational structure and system for collection of data, analysis, monitoring trends and reporting system for disease and nutritional status in the project districts supported by ECHO.
The project strived at the following aspects:
The diseases covered under the surveillance system were: ARI, Diarrhea, Measles, Diphtheria, Whooping Cough, Tetanus, AFP, Tuberculosis, Fever Syndrome, Hepatitis and Malaria. Malnutrition among children, anemias among women and nutritional deficiency disorders (Vitamin A deficiency, Iron deficiency, other micro nutrient deficiency) have also been included. WHO standard case definition were used to identify the diseases and nutritional disorders.
Study Area:
The project was implemented in four districts of Rajasthan; Bikaner, Barmer, Jodhpur and Jaisalmer. The project districts covers an area of around 116882 sq. kilometers with a population of more than 70 million people. These are western districts of Rajasthan, and part of the great desert known as 'Thar'. Majority of the area of these districts is covered by desert. The districts mostly suffer from draught due to scarcity of rains.
The districts are densely populated with poor connectivity, resulting into poor access to the health and other services. The socio-economic status of population in these districts is below the state average regarding majority of the indicators; like, an adverse sex ratio, low literacy level - especially of women, a large proportion of population living below poverty line, etc. A brief demographic profile of these districts is presented in the table given below.
Implementation Structure:
The project was implemented in partnership with the district health system and women and child development department. The implementation of the surveillance system was done through the district health system, and was guided and supervised by IIHMR Core Team, including Faculties and Research Officers. The Chief Medical and Health Officer (CM&HO) at the district level and Medical Officer In-charge at the block level took the major responsibility of implementing the surveillance system. In addition, following personnel were hired on contractual basis to facilitate the implementation:
Project offices were established in all the project district head quarters. Offices were duly furnished with necessary furniture, stationary, computers and printers, etc.
This Surveillance project had two major components:
A. Strengthening Surveillance System B. Rapid Household Survey
The new surveillance system was implemented through the district public health system, whereas, the rapid household survey was conducted by the surveillance supervisors and field investigators hired and trained for this purpose. The details are presented in the following sections.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
534, "A" Wing, Nirman Bhawan, Maulana Azad Road, New Delhi - 110 011 Phone: 91-11-23018955, 23792179, 23793632, 23017993; Fax: 23012450 |