Lessons learnt in implementing a pilot community event-based surveillance system in Tiruvallur district, Tamil Nadu, India

Abstract

ABSTRACT We describe the process and experience of implementing a Community event-based Surveillance (CEBS) pilot project in one district in Tamil Nadu, India. The project was implemented by National Institute of Epidemiology (NIE) in collaboration with the Tamil Nadu State Public Health Department and US Centres for Disease Control and Prevention. The design and process of implementation of the pilot project was developed in collaboration with the Tamil Nadu State Public Health Department. Training materials and an SMS/phone call-based system was developed for community-level reporting. Data pertaining to signals, verified events and response were collected from April – December 2017 and February – December 2019. The frequency of reported signals, the proportion of verified events and the percentage/type of events responded by the health staff were computed. The stakeholders agreed on seven signals for detection of events. Three hundred health workers, 85 doctors and 8214 volunteers were trained. A total of 144 signals were reported of which the three most commonly reported signals were fever with rash (35%), clusters of similar illness (26%) and death of three or more animals or birds in one week (23%). Among the 25 events requiring action, 16 were not reported from existing surveillance systems. The current project demonstrated that CEBS can add value to the existing surveillance systems by engaging the communities to detect and report. Although the current pilot project was implemented in only one district, many important lessons were learnt including, the challenges that should be mitigated before expansion. The State Level leadership is actively exploring ways to strengthen a culture of reporting by initiating programmes that routinely and publicly acknowledge and appreciate reporters and to actively sensitise communities to reduce stigma of reporting.