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Surveillance: Information for action

In 1991, the World Health Organization (WHO) designated surveillance as a critical element in the effort to attain the following objectives: the eradication of polio by 2000, the elimination of neonatal tetanus by 1995, and a 90% reduction in the number of measles cases compared with pre-immunization levels.
WHO considers surveillance of these diseases as one of the four critical elements necessary to attain these objectives. Globally, it is estimated that only 1 in 10 cases of acute polio, I in 20 measles cases and 1 in 33 neonatal tetanus cases are reported. This means that outbreaks are not being investigated, high-risk areas or groups are not being identified, and risk factors are not being corrected.
WHO recommends several key policy elements to strengthen surveillance. They include:
  • Improving timeliness, completeness and accuracy of reporting
  • Circulating standard case definitions
  • Instituting a system of zero reporting if no cases have been seen
  • Establishing outbreak and case investigation, reporting and response
  • Identifying and focusing on high-risk areas and high-risk groups
  • Developing a system for feedback.