Biology Reference
In-Depth Information
In this chapter, the reader will be introduced to the present disease surveil-
lance and notification or control systems practiced in Sri Lanka and Tamil
Nadu. Thereafter, the top-down, bottom-up approach used to develop the
user requirements and the outcome of the process will be described, along
with a preview of future work ahead.
13.2 Sri Lanka Disease Surveillance and Notification System
Sri Lanka is an island off the southern tip of India with a multiethnic popula-
tion close to 21 million. The geography of the tropical country ranges from
a coastal belt to highlands, with a demarcation of wet zones, arid zones, and
dry zones; the average temperature varies between 15° and 40°C. There are
two main seasons, dry and rainy, where southeast and northwest monsoons
hammer the island with heavy rains during the months of April-June and
November-January, respectively, with intermediary showers in-between the
monsoons. Exported labor, tourism, textiles, tea, and spices are the major
source of foreign income. The country is an agricultural society.
13.2.1 National epidemiology unit Organizational Structure
History of disease surveillance in Sri Lanka dates back to the late 19th cen-
tury. The
Quarantine and Prevention of Disease Ordinance
was introduced in
1890 to implement the notification system on communicable disease in the
country. Figure 13.1 shows the institutional hierarchy.
The Director General, Provincial Director, and Regional Director of
Health Services engage in the policy and decision making processes. The
main responsibility of the Chief Epidemiologist is the analysis of surveil-
lance data. The Regional Epidemiologist overseas the regional level decision
making and mediation of surveillance information. The Medical Officer of
Health plays a key role in surveillance and notification by reporting to the
higher levels and launching the actions prescribed by higher levels. The
Public Health Inspector assists in the investigation, reporting, and assist-
ing in the preventive and curative measures in the field.
Suwadana Centre
Volunteers are
part of the Comprehensive Community Health Program of
the Sarvodaya movement, which facilitate primary health care in the vil-
lages, and work alongside the Medical Officer of Health and Public Health
Inspector in their area.
13.2.2 Disease Surveillance and Notification Processes
The Quarantine and Prevention of Disease Surveillance Ordinance in Sri
Lanka states that all medical practitioners or persons professing to treat
