In the context of the global struggle against infectious diseases, effective disease surveillance and response systems are crucially important. Following the success of the smallpox eradication program, vertical donor-dependent infectious disease surveillance systems have been developed in most developing countries. Decreased donor funding in the nineties has left these disease surveillance systems in a poor functional status producing irregular and unreliable information. Based on the experience of Pakistani Ministry of Health, who decided to integrate disease surveillance into a comprehensive facility based health information system; this paper examines benefits and pitfalls of integrated versus vertical disease surveillance systems. In the light of this question, the “usefulness” of surveillance is assessed in terms of its potential to prevent and control infectious diseases, as well as its cost. The Pakistan experience shows that surveillance for most infectious diseases appears to benefit from its integration into a district managed comprehensive routine health information system, both in terms of effectiveness and costs. More scientific evidence is required on how to integrate epidemiological surveillance into decentralized population based routine health information systems. A potential mechanism to coordinate research efforts is the recently created Routine Health Information NetwOrk (RHINO). This network brings together representatives from public health agencies in developing countries, as well as health information system experts, and donor agency representatives to coordinate an action and research agenda on the development of relevant and cost-effective routine health information systems in developing countries.
Learning Objectives: Identify benefits and pitfalls of integrated versus vertical disease surveillance systems
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