Towards Sustainable Public Health Surveillance in India: Using Routinely Collected Electronic Emergency Medical Service Data for Early Warning of Infectious Diseases

Abstract

Infectious disease surveillance, timely detection and early warning of outbreaks present a complex challenge to health authorities in India. Approaches based on the use of unexplored data sources, like emergency medical services (EMS) data, can contribute to the further advancement of public health surveillance capacities in India and support and strengthen the Integrated Disease Surveillance Programme (IDSP) strategy. This research followed a mixed method approach including a series of semi-structured interviews and fever data analysis of the EMS operating dispatch system in Andra Pradesh, India. In this paper, we explore whether routinely collected EMS health data can improve sustainable infectious disease surveillance and early warning capacity. The result highlights the need for improved surveillance systems for early warning of infectious diseases in India. The data availability at the EMS dispatch centre includes patient data and spatial information and can be used for near real-time analysis. Routine data relevant for health surveillance can be extracted to provide timely health information that supplements and enhances more traditional surveillance mechanisms and thus provides a cost-efficient, near real-time early warning system for the operating states. The designed intervention is sustainable and can improve infectious disease surveillance to potentially help the government officials to appropriately prioritize timely interventions to prevent infectious disease spread.

Understanding India’s urban dengue surveillance: A qualitative policy analysis of Hyderabad district

“…Several studies on India's surveillance capacities indicate resource-related challenges, including lacking equipment, tests and human capacities (Gupta & Reddy, 2013;Phalkey, Bhosale, et al, 2013;Pilot et al, 2017;Pilot et al, 2019;Raut & Bhola, 2014;Srivastava et al, 2009;Suresh, 2008). Our findings confirm these resource limitations.…”

“…Considering its re-emergence, rapid spread and the increasing need for richer information, such as spatially segregated data that allow the identification of exact outbreak occurrence and spread, dengue is a disease that requires enhanced public health research and surveillance (Bhatt et al, 2013;Gupta & Reddy, 2013;Sivagnaname et al, 2012). An enhanced public health surveillance system, based on accurate and timely data, is essential to the prediction and detection of dengue outbreaks and ultimately to overall disease containment (Daude & Mazumdar, 2016;Murray, 2007;Pilot et al, 2017).…”

“…Disease surveillance has been and remains a challenging public health task across the subcontinent (Ministry of Health & Family Welfare, 2015). Particularly complex surveillance elements include the accurate monitoring of disease burden and trends, as well as the detection, confirmation and control of outbreaks before disproportional spread and damage (Angelo et al, 2008;Pilot et al, 2017). India's administrative organisation is divided into several layers, consisting of national, state and district units, as well as villages and blocks in rural areas or municipal local bodies and wards in urban regions.…”

“…The effective implementation of such programmes relies on the integration of various stakeholders, inter-sectoral coordination, evidence-based planning, public-private partnerships, crossprogramme cooperation and strong primary health care and public health leadership (Lenka & Kar, 2012;Pilot et al, 2017). The WHO highlights the need to implement national health programmes in ways that are integrative, foster synergies and increase effectiveness, ultimately contributing to the Sustainable Development Goals (Lenka & Kar, 2012).…”

Health-Care Workers’ Perspectives on Preparedness of Health-Care Facilities for Outbreak of Communicable Diseases in Nigeria: A Qualitative Study

“…Only a few talked about training as part of preparedness, 19 routine drills and rehearsal on the handling of emergency situations, and the design and location of infrastructure. The proportion of the respondents that mentioned disease surveillance 20 and immunization 21 as components of preparedness was insignificant, probably because of a lack of understanding of their role/ importance in outbreaks management. The overall knowledge of HCWs on preparedness is very vital in the control of any disease outbreak.…”