The use of epidemiological tools in conflict-affected populations: open-access educational resources for policy-makers

Table of Contents

1. Welcome
2. Introduction: Epidemiology in crises
3. Ethical issues in data collection
4. Need for epidemiologic competence
5. Surveys - Introduction
6. Surveys - Description of sampling methods
7. Surveys - Sampling error, bias, accuracy, precision, & sample size
8. Surveys - Resources required for surveys
9. Surveys - Critiquing survey reports
10. Surveillance - When to do surveillance
    1. What is surveillance?
    2. Why do surveillance?
    3. Steps in carrying out surveillance
11. Surveillance - Methods
12. Surveillance - Common problems
13. Programme data
14. Rapid assessment
15. Mortality - Indicators and their measurement
16. Mortality - Data sources
17. Mortality - Interpretation and action
18. Nutrition - Introduction and background
19. Nutrition - Indicators and their measurement
20. Nutrition - Data sources
21. Nutrition - Interpretation and action
22. Health services
23. Vaccination programmes
24. Water supply, sanitation, and shelter
25. Violence
26. Presentation of results
27. Formulating conclusions and recommendations
28. Dissemination and action

Steps in carrying out surveillance

(go to Outline)

But surveillance involves carrying out many integrated steps by many people:

Reporting

Someone has to record the data. This is usually health care providers who provide clinical care, such as doctors, nurses, clinical officers, etc. They complete a form recording various bits of information about patients seen in their practice.

Data accumulation

Someone has to be responsible for collecting the data from all the reporters and putting it all together. This is often someone in the Ministry of Health, the local health authorities, or the organization coordinating surveillance.

Data analysis

Someone has to look at the data to calculate rates of disease, changes in disease rates, etc. This is often an epidemiologist with specific data analysis and computer skills.

Judgment and action

Someone has to decide, based on the results of analysis, what needs to be done. This is often the public health authorities at the local, provincial, or national level. In emergencies, it is often a joint opinion of local and national health authorities, the organization coordinating health, and all the organizations providing health services.

If any of these steps break down or is unavailable, you will not have usable information with which to take the appropriate (and sometimes necessary) public health action.

So when do we do surveillance?

• When you need continuous data to make immediate clinical and public health decisions

AND

• The basic infrastructure and people are available to gather, transmit, and analyze the data

AND

• You are ready and have the resources to take action based on the data