Establishment
and maintenance of reporting sites:
Reporting
sites (RS) form the backbone of the AFP surveillance network,
and include hospitals and other health facilities -- in the
government or the private sector -- that are likely to see
cases of AFP, as well as informers. Informers comprise pediatricians
and other physicians practicing allopathic medicine, doctors
of indigenous systems of medicine (Ayurvedic, homeopathic,
Unnani), unlicensed practitioners (“quacks”),
and others who are likely to see AFP cases. The RS are geographically
well distributed to cover all areas in the country, to ensure
that there is at least one RS in every block of every district.
At present, 20,491 RUs and informers have been enrolled as
RS, of which 9435 are RUs and 11,056 are informers. Both the
RUs and the informers are expected to report AFP cases immediately;
in addition, the RUs are visited at regular intervals by the
District Immunization Officer (DIO) and the NPSP Surveillance
Medical Officer (SMO) for active surveillance (“active
case searches”) and are also required to submit a weekly
AFP surveillance report to the DIO. This report (weekly “zero”
report) is sent by the facility even if no AFP case was seen
during that week, as a cross-check to ensure that all RUs
are reporting all identified AFP cases. The active surveillance
visits by SMO/DIO to major health facilities ensure that any
missed or unreported AFP cases are detected for timely case
investigation and stool collection. Each RU has a designated
nodal officer responsible for reporting cases, transmitting
surveillance reports and maintaining surveillance records.
Both the SMO and DIO are involved in establishing and maintaining
a sound reporting network, which functions according to established
program guidelines. The SMO and the DIO regularly visit the
RS in their area, providing support such as training, technical
material, reporting forms, updates on the status of polio
eradication in India and globally, and feedback on notified
cases. The approach of repeated visits, giving feedback, solving
problems and streamlining the surveillance process builds
a high level of participation and programme ownership.
