Fahmi Hakam, S.KM., MPH.

Health Information andSurveillance

WHO bulletin special issue 2005:83

Health information system domains

■ health determinants

– socioeconomic, environmental behavioural and genetic factors

■ inputs to the health system and related processes

– policy, health infrastructure, facilities and equipment, costs, human and financial resources and health information systems

■ the performance or outputs of the health system

– availability, quality and use of health information and services

■ health outcomes

– mortality, morbidity, disability, well-being, disease outbreaks and health status

■ health inequities in determinants

– coverage and use of services, and outcomes

Health information data sources

censuses

Civil

registration

Population

surveys

Individual

records

Service

records

Resource

recordsSurveillance

Institution-basedPopulation-based

Essential sources of health-related information

■ Census

■ Vital registration (births and deaths registration)

■ Survey

■ Institution-based data (hospitals, primary health centers)

■ Surveillance program

surveillance

■ Surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health

(Center for Disease Control and Prevention/CDC)

Conceptual framework of public health surveillance and action

McNabb et al. BMC Public Health 2002 2:2 doi:10.1186/1471-

2458-2-2

Epidemic response

Health Policy

Disease control

Incidence data Administrative data

Resource allocation

Health IndicatorsEarly warning information

Response/Action

Epidemic intelligence Health status monitoring

Disease monitoring Health system monitoring

Data information knowledge model

■ Data: is a collection of facts, such as values or measurements

■ Information: data that are processed to be useful; provides answers to "who", "what", "where", and "when" questions

■ Knowledge: application of data and information; answers "how" questions

Source: Adapted from Bellinger, G. Knowledge Management and the Minnesota Department of Health

Health

Communities

Data rich but information poor

Transforming data into information and evidence (WHO)

Why use information technology for surveillance?

■ Improve quality (Completeness, Correctness, Timeliness)

■ Facilitate the use of standard (ICD-10, ICD-9CM, ICPC)

• Maintain security and privacy

• Easier to transform data into

informationPinner (1998); Savel and Foldy (2012)

Modem GSM

Dinas

Kesehatan

Jumantik

Dan petugas

surveilans

(Larvae Tracker)

Analisis & Interpretasi

Feedback Output

Puskesmas

Purpose and use of surveillance

■ Detect epidemics

■ Evaluate control measures

■ Portray natural history of diseases

■ Monitor changes in infectious agent

■ Facilitate planning

■ Generate hypothesis and stimulate research

Estimate magnitude of the program !

Source: anis fuad

Dengue cases in Yogyakarta

Portray natural history of a disease !

Monitor changes in infectious agents !

Percentage of Nosocomial Enterococci Reported as Resistant to Vancomycin in ICU and non ICUs

Detect changes in health practice !

Cesarean Deliveries as a Percentage of all Deliveries in US Hospitals

Facilitate planning !

Number of Reported Tuberculosis Cases

Framework for outbreak detection

Adapted from Buckeridge (2007)

Data Collection

Case detection

Outbreak detection

Public health Action

• Data sources• Sampling

frame, method, frequency

• Case definition• Case

classification

• Algorithm• Threshold• Analysis

frequency

• Interpretation of analysis

• Investigation• response

Baseline cases- Incidence- Variation/

shape

Outbreak cases- Incidence- Variation/

shape- Timing

onset

Source: WHO

SELESAI

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