Question

1. Why is epidemiologic surveillance important for public health? Define pattern and frequency and the distribution of disease? Include a discussion on incidence and prevalence and apply it to the current COVID-19 pandemic

2. Identify and describe the steps of the "PRECEDE-PROCEED" planning framework for designing and evaluating health programs and apply them to a different example.

Answer 1

1.         Public health surveillance is a regular and continuous systematic exercise of collecting, analyzing and interpreting health related data for efficient planning, implementation and evaluation of health practices at mass level. It has been found that in absence of incorrect data tracking related to a pandemic or outbreak, the health programs could not cater the need adequately and hence causes failure of global health initiatives. Most of the time such failures occur in developing countries due to non-availability of data. Thus, strong Surveillance systems are needed that could provide information about the etiology, distribution, and mechanism of infection. For instance – Ebola could be a global threat and hence it need strong surveillance to understand changes in distribution and virulence. Facts about disease distribution and determinants are essential and include the followings –

• Incidence/prevalence

• Severity (case fatality rate)

• Mortality rate

• Productivity loss

• Premature mortality (YPLL)

• Costs in medical care

• Preventability of disease

Frequency of a disease measures its prevalence and its incidence. Where prevalence determines the number of existing patients, the incidence determines the number of new cases arising during a specified period of time. We could see such measurement going on for Novel COVID- 19 outbreak.

2. PRECEDE–PROCEED is basically a model designed for health program planner and policy makers to analyse the current situation and design efficient health programs. PRECEDE - Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation

PROCEED - Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development

The steps involved are –

1. Social Diagnosis – study about factors affecting the quality of life of people

2. Epidemiological, Behavioral, and Environmental Diagnosis – Study about environment and behaviour of people wrt prioritized health needs

3. Educational and Ecological Diagnosis- after step 2, selective factors are worked upon to induce sustainable behavioral change

4. Administrative and Policy Diagnosis

5. Implementation of the Program

6. Process Evaluation

7. Impact Evaluation

8. Outcome Evaluation