Inter-sectoral coordination and social mobilization

1
Inter-sectoral coordination and social
mobilization

• IDSP training module for state and district
  surveillance officers
• Module 12

2
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

3
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

4
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

5
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

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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

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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

8
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

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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

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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

11
Strategizing communication

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

12
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

13
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)

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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)

15
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

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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

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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

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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

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Qualities required for coordination

• Leadership
• Effective communication
• Ability to mobilize people and resources
• Ability to recognize and acknowledge input

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Example Stakeholders involved to respond to an
outbreak of hepatitis E
Stakeholder Potential 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
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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

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Points to remember (2/3)

• The sustainability of the programme depends on
  the extent of inter-sectoral and intra-sectoral
  coordination
• Peoples participation is key to
• Complete coverage
• Timely reporting
• Integrated and coordinated surveillance will
• Pooling / share resources
• Avoid wastage / improve efficiency
• Ensure quality and sustainability

23
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