International Health

Before the launch of standard National Health Information System (NMHIS) in 2000, there had been acute paucity of reliable and timely health information in Pakistan. Health Departments had no choice than to resort to estimates or carry expensive community based surveys to determine the disease incidence. After the development and deployment of NHMIS, overall Health System is reshaping itself based upon the regular and frequent information now available on a good number number of priority health problems. This is system is now offering tremendous opportunities for promoting the cause of evidence based decision making and monitoring of its expanded health care structure. This effort had led to putting in place a standard system of data collection and transmission from roughly 13000 public health services (both urban and rural ). The new system is now able to promptly locate pockets of vulnerable communities reporting high disease incidence.

Objective

Purpose of this abstract is to show how launch of a standard National Health Information System is has become the main national data source, and is, playing a pivotal role in facilitating decision making in health care system in Pakistan.

In June 2004, the French syndromic surveillance system based on the ED has been implemented by the French institute for public health surveillance (InVS), starting with 23 ED. In August 2014, about 600 ED (40,000 daily attendances) are included in the Oscour network, recording 80% of the national total attendances.

Asthma is one of the about 60 syndromic indicators monitored each day and followed all over the year.

This indicator presents important fluctuations and can be influenced by several environmental and infectious but also societal factors. Particularly factors like air pollution are known to have both short and long term impact on asthma while thunderstorms are associated with acute outbreaks of asthma.

Objective

Description of the temporal pattern of the daily number of attendances in emergency departments (ED) for asthma in Paris area and identification of the main factors influencing this indicator.

During the past ten years, the syndromic surveillance has mainly developed thanks to clinical data sources (i.e. emergency department, emergency medical call system, etc.). However, in these systems, the population doesn’t play an active role. It is now important that the population becomes an actor of this surveillance; especially since several European experiences about influenza showed that the population could participate to an internet-based monitoring. In Reunion Island, the population is very sensitive to public health concerns. In this context, the health authorities implemented since April 2014 a web-based surveillance system, called “Koman i lé”, that allows to follow the perceived health among people who don’t systematically see their general practitioner.

Objective

To describe a new surveillance system based on an online selfreported symptoms and to present the first results.

Infectious disease outbreaks during crises can be controlled by detecting epidemics at their earliest possible stages through cost effective and time efficient data analytical approaches. The slow or non reporting is a real gap in existing reporting systems that delays in receiving the disease alerts and outbreaks, and hence delays in response causing high burden of morbidity and mortality, especially during crises situation. As on contrary, the functioning electronic databases for fast and reliable disease early warning and response networks (EWARN) have been found very effective in early detection, confirmation and response to disease outbreaks but launching the implementation of such systems is always time consuming due to resource constraints and other limitations during crises. Hence introduction of time efficient data analytical approaches can serve as a fast and reliable alternative for electronic databases during the launching phases, and may facilitate assessment of epidemics and outbreak situation by ensuring immediate, reliable and fully functional disease reporting and analysis until online database becomes fully functional and adopted by authorities.

Objective

To assess the epidemic and outbreak situations during emergencies through development and application of a data summarization techniques while launching electronic disease early warning systems (eDEWS) in resource poor countries

Integrated Disease Surveillance and Response (IDSR) is a World Health Organization (WHO) Regional Office for Africa (AFRO) strategy for strengthening national public health surveillance and response systems in African countries. The strategy incorporates the International Health Regulations (2005) core capacities for public health surveillance and response systems. Since 2010, more than 30 countries have conducted at least one IDSR training workshop. Limited resources preclude conducting workshops in each of the 4,500 districts in all WHO-AFRO region. One solution is to implement an electronic version for IDSR training.

In collaboration with WHO-AFRO, we conducted a literature search to identify e-Learning best practices, and transformed the IDSR workshop training materials into electronic modules using measurable performance objectives, realistic examples, meaningful practices, and real time feedback to the learner. We also utilized an online learning management platform that lets course managers track learner progress and share supporting materials. The IDSR e-Learning course, available in English, French and Portuguese, aims to increase access to skills that support the prevent-detect-respond goal areas of the Global Health Security Agenda.

Objective

This presentation addresses the challenges of expanding district level surveillance training in Africa. We developed an e-Learning course and field tested the modules using an innovative approach to assess the feasibility of delivering electronic surveillance training.

The burdens of poverty and disease continue to affect the livelihoods of pastoralists in Tanzania. Their knowledge of seasons and the ecosystems has evolved over years to manage human and animal health problems, including food insecurity. But, both local and global factors are putting pressure on their knowledge base and their capacity to manage health issues, this conflict has not been adequately explored nor have the synergies between indigenous and exotic knowledge.

Objective

To collect and assess indigenous knowledge and practices to manage diseases of food security as well as create opportunities to disseminate results for improving self-help.

Existing EVD surveillance strategies in Sierra Leone use a centralized live alert system to refer suspect cases from the community to Ebola treatment centers. As EVD case burden declined in Port Loko District, so did the number of reported alerts. As EVD presents similarly to malaria, the number of alerts reported are expected to remain consistent with malaria prevalence in malaria-endemic areas, irrespective of a reduction in true EVD cases. Declines in reported suspect cases from the community alluded to the possibility that individuals were returning to healthcare centers to seek treatment for malaria, and that PHUs were not adequately reporting suspect EVD cases. District surveillance officers (DSOs) were used to investigate the usage of PHUs by community members, as well as the mechanisms that health center staff used in recording patient visits. Surveillance methods specific to PHUs were introduced to increase the number of reported EVD alerts, as well as establish the foundation for future integrated disease surveillance response strategies.

Objective

A community-based EVD surveillance system with improved symptom recording and follow-up of malaria positive patients at PHUs was implemented during low EVD transmission. The rationale and methodology in implementing a PHU-focused approach to strengthen surveillance system sensitivity is described.