Inter-sectoral coordination and social mobilization IDSP training module for state and district surveillance officers Module 12

Learning objectives (1/2) Describe the strategies and action plan to mobilize community participation Describe surveillance activities related to existing vertical disease control programmes at the district level to facilitate integration

Learning objectives (2/2) Describe the strategies and action plan to mobilize community participation Describe surveillance activities related to existing vertical disease control programmes at the district level to facilitate integration

Coordination The process of linking the activities of various departments of an organization The process by which managers achieve integrated patterns of group and individual effort  i.e., Develop unity of action in common purposes The integration, synchronization or orderly patterning of group efforts by an organization towards the accomplishment of common goals or objectives

Cooperation and collaboration Cooperation  Collective effort put willingly and voluntarily by a group in the performance of any work  No time quality or directional framework Collaboration  The joint conduct of programme or project  Emphasizes the sharing of similar responsibilities on the basis of an agreement

Inter-sectoral versus intra-sectoral coordination Intra-sectoral coordination  Coordination within an organization between its various subsystems and units or agents Inter-sectoral coordination  Coordination with non-health organizations, sectors or agencies to achieve goals

Intra-sectoral coordination The final common pathway  Grass root level Same people conduct surveillance for various programmes and agencies  From district level onwards Information goes through various channels Integration of surveillance activities from various programmes  One of the primary objectives of the programme  Key determinant of sustainability

Inter-sectoral coordination Various health and non-health departments need to share information generated by the surveillance mechanisms Need for effective sharing of information on surveillance with all stakeholders  Health department  Other governmental and non-governmental agencies

Stakeholders Medical officer of primary health centres Sentinel private practitioners Community representatives District  All members of the district surveillance unit State  All members of the state surveillance unit

Aim of the social mobilization campaign Create awareness among:  Partners  Private practitioners  Non governmental organizations  Community Establish an institutional mechanism to involve community and their leaders  Rotating membership in: District surveillance committee Block surveillance committee

Strategizing communication Adapt message and format to the audiences Consider all media  Electronic media  Press  Hoardings  Handbills  Posters  Inter-personal communication through health providers

Feedback strengthens effective inter- sectoral and intra-sectoral coordination Sharing of information with all stakeholders Share regular reports at the state and district levels  Make available on line / electronically

Community stakeholders Persons to involve  Anybody who can provide information on the possible occurrence of the diseases School teacher, informal community leader Ways to involve community representatives  Share information (Feedback)  Obtain information (Listen)

Being close from the community People volunteer in areas where health workers enjoy a good relationship with their communities Individual initiatives taken by enthusiastic health staff make a difference Key contacts  Village elders’  Ladies  Pradhan (Village head)  Panchayat members  Chowkidar (Village guard)

Socio-cultural issues Socio-cultural barriers and gender disparities may influence the sensitivity of data collected  Religious minorities may distrust the public sector  Urban clients in high rise may not use public system  Poor may feel neglected in the public sector Social mobilization campaign need to address all these socio-cultural beliefs

Engaging medical colleges Responsibility of the state surveillance unit  Memoranda of understanding Selection of a coordinating medical college by the Director of Medical Education Facilitation by the health secretary Possibility for medical colleges to work in urban surveillance Contacts at the central level will facilitate these synergies

Institutional Integrated Disease Surveillance Project sub-committee within medical colleges Principal / superintendent  Report to Integrated Disease Surveillance Project Community medicine Medicine Pediatrics Chest and tuberculosis Microbiology Cardiology

Additional potential roles of medical colleges Reference laboratories Quality assurance and evaluation Training Outbreak investigations  In collaboration with the district surveillance officer / medical officer Non communicable disease risk factor surveillance

Qualities required for coordination Leadership Effective communication Ability to mobilize people and resources Ability to recognize and acknowledge input

Example: Stakeholders involved to respond to an outbreak of hepatitis E StakeholderPotential role Health Surveillance Case management Coordination Water board Investigation of the water supply Repairs Animal husbandry Investigation of possible animal reservoirs Media Information, education and communication Non-governmental organizations Community participation

Points to remember (1/3) IDSP is a new initiative that requires integration and coordination within and between different departments All surveillance activities will need to be coordinated under the district surveillance officer Inter-sectoral coordination is perhaps the biggest challenge in implementation of the programme

Points to remember (2/3) The sustainability of the programme depends on the extent of inter-sectoral and intra-sectoral coordination People’s participation is key to:  Complete coverage  Timely reporting Integrated and coordinated surveillance will:  Pooling / share resources  Avoid wastage / improve efficiency  Ensure quality and sustainability

Points to remember (3/3) The medical officer / district surveillance officer will need to use the inter- departmental coordination committee to bring up:  Positive products of the cooperation  Non-action / non-reporting The leadership, commitment and communication skills of the medical officer / district surveillance officer will be critical