January 24, 2021: India is focusing on its health system reforms to ensure that the Public Health Surveillance systems are made citizen-centric and contribute to the overall socio-economic development of the country. Hence, on December 14, 2020, Vision 2035: Public Health Surveillance in India was published by the NITI Aayog, which recommended improving India’s Public Health Surveillance (PHS) by introducing a surveillance information system.
A white paper is an informational document, usually issued by a company or not-for-profit organization, to promote or highlight the features of a solution, product, or service.
NITI Aayog’s mandate is to provide strategic directions to the various sectors of the Indian economy.
The Health Vertical released a set of four working-papers compiled in a volume entitled ‘Health Systems for New India: Building Blocks-Potential Pathways to Reforms’ during November 2019.
This white paper is a continuation of the work on strengthening the health systems.
The White Paper on Public Health Surveillance
NITI Aayog has released a white paper Vision 2035 – Public Health Surveillance in India. This paper is a joint effort of Health Vertical, NITI Aayog, and Institute for Global Public Health, University of Manitoba, Canada with contributions from technical experts from the Government of India, States, and international agencies.
The white paper lays out India’s vision for public health surveillance through the integration of the three-tiered public health system into Ayushman Bharat.
It also spells out the need for expanded referral networks and enhanced laboratory capacity. The building blocks for this vision are an interdependent federated system of governance between the Centre and states.
It contributes by suggesting mainstreaming of surveillance by making individual electronic health records the basis for surveillance.
Main Features of the Public Health Surveillance system
● Strengthens non-communicable disease prevention, detection, control and to reduce out of pocket expenses of individuals and families.
● It builds on initiatives such as the Integrated Health Information Platform of the Integrated Disease Surveillance Program.
● Aligns with the citizen-centricity highlighted in the National Health Policy 2017 and the National Digital Health Blueprint.
● It encourages the use of mobile and digital platforms and point of care devices and diagnostics for amalgamation of data capture and analyses.
● It highlights the importance of capitalizing on initiatives such as the Clinical Establishments (Registration and Regulation) Act 2010 to enhance private sector involvement in surveillance.
● It points out the importance of a cohesive and coordinated effort of apex institutions including the National Centre for Disease Control, the Indian Council of Medical Research (ICMR), and others.
● To make India’s Public Health Surveillance system more responsive and predictive to enhance preparedness for action at all levels.
● To make it more citizen-friendly to ensure individual privacy and confidentiality, enabled with a client feedback mechanism.
● To improve data-sharing mechanisms between the centre and states for better disease detection, prevention, and control.
● To provide regional and global leadership in managing events that constitute a public health emergency of international concern.
Public Health Surveillance
PHS is an important public health function that cuts across the three-tiered public health system and care provided. Surveillance is information for action and is an essential action for disease detection, prevention, and control.
Going forward, India would see a public health survey focused on individual EHRs that, with the help of UHID, collect and amalgamate the health-care related information of individuals.
This mechanism will be used for any visit to the clinic, laboratory, or pharmacy and for vertical monitoring programmes for disease. Routine surveys are designed as additional complementary tools to reassess disease/risk factor occurrence and prevalence, to regularly modify and refine standard case descriptions, outbreak thresholds, and refine the levels and indicators of response.
A platform for surveillance information can store, review, and auto-generate appropriate action reports. This remains a repository for further study and studies that will complement the surveillance information available in the system.
Rajiv Kumar, the vice chairman of NITI Aayog, said India has made significant progress in the prevention, control and elimination of major communicable diseases.
It is time to improve non-communicable disease surveillance and to replace conventional data entry surveillance systems with recent advances in digital health and technology, in line with the National Digital Health Mission.