|BRIEF RESEARCH ARTICLE
|Year : 2022 | Volume
| Issue : 2 | Page : 196-199
Kasurdi health and demographic surveillance system: A profile and way forward
Arun Kumar Yadav1, T Prabhakar Teli1, Sanjay K Juverkar2, Rahul Kumar3, Renuka Kunte4, Dharamjeet Singh Faujdar1
1 Associate Professor, Department of Community Medicine, AFMC, Pune, Maharashtra, India
2 Professor and Head, Vadu Rural Health Program, KEM Research Centre, Pune, Maharashtra, India
3 Resident, Department of Community Medicine, AFMC, Pune, Maharashtra, India
4 Professor, Department of Community Medicine, AFMC, Pune, Maharashtra, India
|Date of Submission||08-Jun-2021|
|Date of Decision||17-Nov-2021|
|Date of Acceptance||14-Dec-2021|
|Date of Web Publication||12-Jul-2022|
Arun Kumar Yadav
Department of Community Medicine, AFMC, Pune - 411 040, Maharashtra
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Kasurdi Health and Demographic Surveillance System (Kasurdi HDSS) was established at Rural Health Training Center Kasurdi on February 16, 2018. Kasurdi HDSS has been established to increase the research potential of medical colleges and develop real-time data for research purposes to study the changes in population demography, health, and health-care utilization. Kasurdi HDSS currently follows 2755 individuals living in 549 households. The system collects the data from the population through annual rounds conducted by postgraduate residents of the department of community medicine. The data are collected in the digital format with the help of android-based tablets. HDSS has collected demographic data, reproductive data, data on diseases such as tuberculosis and noncommunicable diseases, and socioeconomic data. The HDSS is in the process to upgrade its data management system to a more integrated platform, coordinated and guided by national/international standards, and data sharing policy.
Keywords: Health and Demographic Surveillance System, Kasurdi, noncommunicable diseases, reproductive health, rural health training center, socioeconomic status
|How to cite this article:|
Yadav AK, Teli T P, Juverkar SK, Kumar R, Kunte R, Faujdar DS. Kasurdi health and demographic surveillance system: A profile and way forward. Indian J Public Health 2022;66:196-9
|How to cite this URL:|
Yadav AK, Teli T P, Juverkar SK, Kumar R, Kunte R, Faujdar DS. Kasurdi health and demographic surveillance system: A profile and way forward. Indian J Public Health [serial online] 2022 [cited 2022 Aug 16];66:196-9. Available from: https://www.ijph.in/text.asp?2022/66/2/196/350642
Identifying, collecting, analyzing, interpreting, and disseminating data are major components of any primary health-care delivery system. Information is required to effectively carry out the planning, management, direction, and evaluation of health-care programs. There are significant gaps in effectively managing health due to failure in recognizing data as an integral component of the system in providing health care.
National and other established health and demographic surveys in developing countries such as India are carried out once in 5–10 years, and many of these surveys are sample-based. Health and Demographic Surveillance System (HDSS) provides a longitudinal assessment of health and demographic changes that have taken place over time in the population. It also complements to fill in the data gaps. The Kasurdi HDSS has been set up in the rural areas to provide a comprehensive assessment of population demography and regularly provide information on their health status. It is anticipated that the data generated through HDSS will boost primary health care, which is aimed to reduce morbidity, disability, and mortality at a much lower cost and significantly reduce the need for secondary and tertiary care.
Kasurdi is located in Daund taluka of Pune district in Western Maharashtra state. It is under Khamgaon Primary Health Center (PHC). Khamgaon PHC has four subcenters (SC), namely Khamgaon SC, Sahajpur SC, Boriyendi SC, and Bharatgaon SC. Kasurdi village comes under Bharatgaon SC. The geographical coordinates, i.e., latitude and longitude of Kasurdi, are 18.207242 North and 73.902876 East, respectively [Figure 1].
The total geographical area of the village is 528.53 hectares. Kasurdi village is located about 40 km from Pune, off the Solapur highway, and its topography is semi-hilly terrain. Kasurdi village comprises Gaikwad, Malwadi, Bhondave, Tambe, Sonawane, Veer, and Khamgaon Phatta bastis. The village has a population of 2755 as per Population Census 2011 and has 549 families. As per India and Panchyati Raaj Act's Constitution, Kasurdi village is administrated by sarpanch (head of the village), who is elected representative of the village.
Kasurdi has a sex ratio of 950 females for every 1000 males and a literacy rate of 71.2% among the females and 88.5% among the males. About 86% of the villagers are believers of Hinduism, 9% are followers of Buddhism, and 4% have faith in Islam. According to the 2011 census, 31.25% of the population belongs to the scheduled castes and 2.94% to the scheduled tribes.
HDSS required a continued core research staff due to the longitudinal nature of data collection in HDSS. Moreover, the partnership is required to share experiences and provide expertise support for the data management that is needed daily for long-term running of HDSS. As a step toward sustaining Kasurdi HDSS, to overcome the above two very crucial challenges, Kasurdi HDSS has partnered with Vadu HDSS run by Vadu Rural Health Program (www.kemhrcvadu.org) of the KEM Hospital Research Centre Pune.
The preliminary meeting was held with the Vadu HDSS to finalize the tools for data collection. For uniformity of data collection and comparability of the Kasurdi site and Vadu site, forms of Vadu HDSS were adopted. Multiple brainstorming sessions were conducted with Vadu HDSS team to finalize the data collection forms and their sequences of administration and modality of data collection. Vadu HDSS team provided training to Kasurdi HDSS team.
In the first round of data collection, the three forms, namely baseline form, morbidity and risk factors form, and socioeconomic status forms, were selected for data collection. For finalizing the data collection forms, a committee was formed which comprised epidemiologists, biostatisticians, anthropologists, medical officers in charge of Rural Health Training Center, and a member of the society. After the development of the forms, these were pilot tested in Kasurdi village, and necessary changes were incorporated after field evidence and discussions in the committee. The data collection forms were further digitalized by Vadu HDSS and converted into an Android-based app. The forms were made bilingual in English and Marathi in the tablets. Logic checks and skips are inbuilt in the form.
The baseline data collection or the first surveillance round was conducted (from January 2019 to May 2019) by the Department of Community Medicine's 1st-year residents with support from the medical social workers and health assistants of the department. All households of Kasurdi village are part of the Kasurdi HDSS. The first round covered a total of 498 households out of the 549 households of the village. Data collection from the remaining 51 households was not possible due to their unavailability even after three repeated visits on different occasions. HDSS was given ethical clearance from Institute Ethical Committee.
The health and demographic data from the Kasurdi HDSS for the year 2019 and it's comparison with census 2011 are summarized in [Table 1]. As compared to census 2011, we found that literacy rate and houses with electricity have increased.
|Table 1: Basic demographic and socioeconomic characteristics of study population during 2019 at Kasurdi Health and Demographic Surveillance System and its comparison with census 2011|
Click here to view
The comparison of few of the characteristics of Kasurdi HDSS with National Family Health Survey 4 (NFHS 4) data is summarized in [Table 1]. The baseline round of HDSS shows that the average household size is 4.93 in Kasurdi HDSS, which is similar to 4.9 in rural India. The sex ratio of 950 is low as compared to that of NFHS-4 India (rural) and Maharashtra (rural) data. However, it is comparable to Birbhum HDSS and is better than Ballabgarh and Vadu HDSS.,, The sanitation facilities in Kasurdi HDSS (91.6%) are significantly better than NFHS-4 India (rural) and Maharashtra (rural) figures. The number of households (94.4%) using clean fuel for cooking is substantially higher than NFHS-4 India (rural) and Maharashtra (rural) figures. The active response of the people and activities carried out by the college for increasing awareness and utilization of the Yojnas such as Swachh Bharat Mission, Pradhan Mantri Ujjwala Yojana, and cooperation of the office bearers may have an association with it.
More than 50% of the population is under 30 years of age. The dependent population, defined as population younger than 15 and elder than 64 to the population 15–63, is 35% compared to national data that shows 50% of the dependent population. A total of 294 (59%) of the households in our study area are joint families, and 184 (37%) are nuclear families. A total of 449 (90.2%) households of the study area are permanent residents of the area; however, 49 (9.8%) households are migrant residents who have migrated into the area mainly for employment. In the structure of the household, 269 (54%) of the households are pucca, 194 (39%) are semi-pucca, and 35 (7%) are kuchha.
One in five households (96/498) was found to have a case of hypertension, and one in eight households (64/498) was found to have a diabetic member. Eighteen and three households had a case of asthma and cancer, respectively.
The socioeconomic status of the households was measured using the BG Prasad Scale. Almost 40% of the households fall in the lower class as per the BG Prasad socioeconomic scale. According to the BG Prasad scale, 198 (39.8%), 87 (17.5%), 83 (16.7%), 92 (18.5%), and 38 (7.6%) households belong to lower, lower-middle-class, middle class, upper-middle-class, and upper class, respectively.
Kasurdi HDSS has multiple strengths, which gives confidence in its long-term sustainability. First, as it will be an extension of the medical institute, it assures long-term support in actual data collection, capacity building, and providing quality care to the rural population.
Quality data collection tools and procedures would help in ensuring a reliable database for community research. In addition, intense monitoring and supervision of its surveillance activities, followed by independent quality checks incorporated at various health and demographic surveillance activities, ensure the robust quality of the generated data.
Funding for HDSS would remain the most significant challenge as it is a long-term process with yearly follow-up. Another challenge ground staff faces is the disparity in government records that did not match existing ground reality.
The immediate plans are to involve local health workers or volunteers to fill HDSS forms with the help of the local administrator. To facilitate the above, the data collection form has been made bilingual. The filling of the form using digital tablets has been tested among grass-root level workers. The advantage of involving health administrators is in the continuity of the process. The entire population of the Khamgaon PHC (approximately. 30,000) is planned to be covered under Kasurdi HDSS. The data of noncommunicable diseases (NCD) would be utilized for further studies to delineate the significant risk factors for the same, and multipronged strategies would be devised to prevent these NCD. The data on pregnant mothers, adolescent girls, and women in the reproductive age group would be utilized for operational research on reproductive health. Kasurdi HDSS may also upgrade itself to become a member of a national network under making which is “Network of HDSS in India” and/or International Network for the Demographic Evaluation of Populations and their Health.
Kasurdi HDSS would be a trusted source for evidence supporting and evaluating progress toward health and development goals with the aim to conduct population-based research, leveraging its longitudinal tracking by stimulating, facilitating, and conducting cutting-edge multicenter research. The successful completion of the first round of data shows that it is feasible. However, sustained efforts, support of all stakeholders, and updation of expertise are required for its continued functioning.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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