16
STRATEGIC FRAMEWORK FOR WHO TECHNICAL AND COUNTRY WORK:
GeTTInG THe RIGHT foCUs
3.1 Surveillance, risk assessment and response
Surveillance, risk assessment and outbreak response capacity is a prerequisite for efecive management of emerging disease outbreaks and other acute public health
events. Efecive naional surveillance systems generate reliable informaion for imely risk assessment that informs rapid public health acions.
3.1.1 Key components
The key components required for an efecive system of surveillance, risk assessment and response at the naional and local levels are:
• event-based surveillance EBS; • indicator-based surveillance IBS;
• risk assessment capacity; • rapid response capacity;
• ield epidemiology training FET. EBS is the organized and rapid capture of informaion about events that are a potenial
risk to public health. Informaion may be found in internet-accessible informaion sources such as news media sites, disease reporing networks, and other ad hoc reports
transmited through formal and informal channels. EBS can provide near real-ime data on potenial and conirmed disease outbreaks and other public health events,
including events related to the occurrence of disease in humans, such as clusters of cases of disease and events related to potenial human exposure e.g. diseases and
deaths in animals, contaminated food or water, and environmental hazards, including chemical, radiological and nuclear events.
Figure 3.1 Surveillance, risk assessment and response framework
Indicator-based Surveillance
Routine reporting of cases of disease, including:
• notiiable disease surveillance systems
• sentinel surveillance • laboratory-based surveillance
Commonly: • Health care facility-based
reporting • Weekly, monthly reporting
Indicator-based Surveillance
Routine reporting of cases of disease, including:
• notiiable disease surveillance systems
• sentinel surveillance • laboratory-based surveillance
Commonly: • Health care facility-based
reporting • Weekly, monthly reporting
Event-based Surveillance
Rapid detection, reporting, conirmation and assessment of
public health events including:
• clusters of disease • rumours of unexplained deaths
Commonly: • Immediate reporting
Event-based Surveillance
Rapid detection, reporting, conirmation and assessment of
public health events including:
• clusters of disease • rumours of unexplained deaths
Commonly: • Immediate reporting
Response
Linked to surveillance National and subnational capacity to respond to alerts
Response
Linked to surveillance National and subnational capacity to respond to alerts
Risk Assessment
seCTIon 3: foCUs aReas and aCTIons
17
IBS is the systemaic collecion and analysis of imely, reliable and appropriate data on priority diseases, syndromes and condiions. Data collecion follows a predeined
format and includes speciic case or syndrome deiniions. Data reporing and analysis occur regularly, typically once a week, and alert or epidemic thresholds are oten used
to idenify outbreaks. IBS aims at outbreak detecion, monitoring of disease trends and disease control programmes and programme planning. Use of appropriate informaion
and communicaion technology ICT tools may aid in improving the quality of collecion and collaion of surveillance data at the naional and local levels.
Risk assessment is a systemaic process for gathering, assessing and documening informaion to assign a level of risk for a potenial public health event. This enables
objecive evidence-based decisions while giving consideraion to the uncertainies and limitaions of the informaion available at a paricular point in ime. It involves
understanding the idenity and character of a hazard and evaluaing the risk of an adverse outcome in a populaion following exposure to that hazard. The process can
also assess the risk associated with potenial intervenion measures. During an event, risk assessment is an ongoing process, not a one-ime acivity.
Rapid response capacity in this context refers to the ability to mobilize a rouine and rapid invesigaion of and response to public health events at naional and local levels.
This includes development and deployment of rapid response teams RRTs to any level in the public health sector.
IBS and EBS are complementary and both are essenial components of naional surveillance systems. Surveillance informaion is used to help risk assessment, which in turn informs
public health acions. Surveillance, risk assessment and response oten require efecive mulilevel, mulidisciplinary and mulisectoral coordinaion.
Kategori