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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
http://fahmi-hakam.blogspot.co.id/
https://www.slideshare.net/FahmiHakam
https://www.researchgate.net/profile/Fahmi_Hakam2