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ABSTRACT
Dengue's re-emerging epidemiology poses a major global health threat. India contributes significantly to the global communicable disease burden has been declared highly dengue-endemic, exposing public health authorities to severe challenges. Our study aims to provide a deeper understanding of India’s urban dengue surveillance policies as well as to explore the organisation, functioning and integration of existing disease control pillars. We conducted a qualitative regional case study, consisting of semi-structured expert interviews and observational data, covering the urban region of Hyderabad in South India. Our findings indicate that Hyderabad’s dengue surveillance system predominantly relies on public reporting units, neglecting India’s large private health sector. The surveillance system requires further strengthening and additional efforts to efficiently integrate existing governmental initiatives at all geographical levels and administrative boundaries. We concluded with recommendations for improved consistency, accuracy, efficiency and reduction of system fragmentation to enhance the integration of dengue surveillance and improved health information in urban India. Finally, our study underlines India’s overall need to increase investment in public health and health infrastructures. That requires coordinated and multi-level action targeting the development of a competent, effective and motivated public health cadre, as well as truly integrated surveillance and epidemic response infrastructure, for dengue and beyond.
Acknowledgements
The research presented in this article is embedded within the Memorandum of Understanding (MoU) between the Public Health Foundation of India and Maastricht University. The authors thank Bart Penders, Anja Krumeich, and David Townend for input on the final draft. Further the authors would like to thank Hyderabad Municipality, the Hyderabad district IDSP and NVDSP for their contribution and input to the study. E.P. and V.N. contributed to the conception, design, analysis, and interpretation of data. E.P. and V.N. drafted the manuscript. G.V.S.M. substantially revised it; all authors have approved the submitted version and agree to be personally accountable for their own contributions and for ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated, resolved, and documented in the literature.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
Qualitative interview data is not made available due to privacy concern.