What is public health surveillance and what is its importance?

Explain some barriers to data

sharing in public health?

Public health surveillance is the ongoing systematic collection, analysis, and interpretation of
data, closely integrated with the timely dissemination of these data to those responsible for
preventing and controlling disease and injury
(Tulane University school of Public Health and Tropical Medicine, 2023)
. The goal of surveillance is to provide decision makers with the
necessary tools to efficiently oversee and advance prompt, evidence-based remedies. The
definition of health surveillance, its significance, and some obstacles to data sharing in public
health will be the main topics of this assignment.

The systematic, ongoing process of estimating population health and behaviour is known as
public health surveillance. Both passive and active surveillance technologies are available. While
there is a chance that some infections will go unreported while using passive monitoring
techniques, they are also quick and affordable. Active surveillance systems work best in
epidemic situations because they eradicate specific diseases. (University of Cambridge, 2023)

Importance of surveillance
 A method for estimating the health and behaviour of the populations that ministries of
health, ministries of finance, and donors serve is public health surveillance.
 Surveillance plays a critical role in assisting nations in tracking and assessing new
disease patterns and trends.
 Countries are able to establish goals and create focused measures to stop disease
epidemics thanks to the data gathered; surveillance is essential since it helps with
improved disease prevention and management.
 Monitors and clarifies the epidemiology of health problems, guiding priority-setting and
planning and evaluation public health policy and strategies;
 Facilitates monitoring and evaluation of the impact of an intervention,
 Aids in tracking progress towards specific goals
 Acts as an early warning system for impending outbreaks that could become public
health emergencies.
 detecting ill-health effects at an early stage, and ensure better controls to prevent them
getting worse
(WHO, 2023)
Barriers to data sharing in public health

Technical barriers

Aspect Description

Data not collected There are large gaps in public health data systems, especially in low- and
middle-income countries, according to the WHO Health Metrics Network,
the CDC/USAID Data for Decision Making project (DDM), and other
agencies. Many nations' disease surveillance programmes fall short of the
2005 International Health Regulations' requirements.
Data on public health are frequently gathered for immediate uses, such
Data not preserved identifying outbreaks. Frequently, data archiving and preservation are not
or cannot be found given priority, particularly when capacity and resources are scarce.

1. Regularly gathered public health data are frequently kept in local tongues,
Language barrier which makes it more difficult to combine and utilise them with other data
sets, especially when doing so internationally.
A significant amount of public health data, including disease surveillance
Restrictive data and administrative data, is still gathered and maintained in hardcopy paper
format format or in electronic format that may be outdated or incompatible with
contemporary software systems, despite significant advancements in
computational resources in the field of public health.
(Willem G van Panhuis, 2014)
Technical software solutions to collect, harmonize, integrate, and share
Technical complex and heterogeneous data have been developed in the private or
solutions not research sector, but have not become widely available to public health
available agencies.

Metadata that describes data substance, origin, technique, etc. is often

Lack of metadata absent from public health data. The underutilization of standards for data
and standards format, variables, and metadata also commonly limits the use of secondary
data and interoperability.

Motivational barriers
These include barriers based on personal or institutional motivations and beliefs that limit data
sharing.
 Personal and institutional incentives are often required to prioritize data
No incentives sharing over other pressing duties, particularly if the benefit of data sharing
is delayed and uncertain
Public health officers may worry that if data recipients with higher
Opportunity cost analytical skills end up receiving the majority of the credit, they won't
receive the scientific credit they deserve or other opportunities.
Errors discovered during the secondary use of data providers' data could
Possible criticism lead to their disgrace, and data that shows ongoing illness recurrence could
lead to criticism of disease management initiatives.
Data providers may disagree with the intended secondary use of their data
Disagreement on or may consider their data inappropriate for a certain use.
data use

Economic barriers
These barriers concern the potential and real cost of data sharing (WHO, 2022)

Possible economic Public sharing of disease outbreak data, for example, can result in
damage. economic damage due to reduced tourism and trade This can lead to
reluctance among health agencies to rapidly release disease data.

Lack of resources Human and technological resources are needed and under economic
pressure or in low-income environments, public sector institutions usually
lack these resources.

Political barriers
These are fundamental structural barriers embedded in the public health governance system that
are grounded in a political or socio-cultural context.
Lack of trust Trust between a data provider and user greatly enables data sharing. In the
absence of trust, providers could anticipate potential misinterpretation,
misuse or intentional abuse of the data .
Restrictive policies Agencies may have developed official policy guidelines that restrict data
sharing, resulting from various possible underlying factors such as a
general sense of distrust, negative prior experiences, or other factors

Lack of guidelines Frequently, official guidelines on data sharing simply do not exist, are
unclear or inconsistent.

Legal barriers
These barriers are legal instruments used to restrict data sharing, resulting from the underlying
willingness (or not) to share data.
Ownership and Agencies that collect public health data are often responsible for the
copyright protection of individual and community privacy and may feel that a
 guardianship or ownership role is bestowed on them by the public. This
could result in a default of restricting access to most data .
Protection of Under the Health Insurance Portability and Accountability Act (HIPAA) in
privacy the US and comparable laws in other nations, public health agencies are
mandated and authorised to gather personal health information from the
general public. Due to privacy issues, it could not always be able to
distinguish clearly between data that contains personal identifiers and data
that is completely anonymous, which could result in restrictive regulations
on all types of data.

Ethical barriers
These are normative barriers involving conflicts between moral principles and values.
Lack of This refers to the thorough consideration of the dangers and advantages
proportionality that result from the type and quantity of data requested in comparison to
the possible impact of its secondary use. (Peter Nsubuga, 2006)
Lack of reciprocity Data producers have often felt exploited in transactions where they receive
little credit or benefit from their work, while data users that can rapidly
analyze data and publish results benefit from academic credit and career
advancement as has happened in the past
 Interactions between barriers and solutions to public health data sharing

Motivational Economic
Technical Political Legal
• No incentives • Possible Ethical
• Data not • Lack of trust • Ownership and
• Opportunity cost economic • Lack of
collected • Restrictive
• Possible damage copyright proportionality
• Data not policies
criticism • Lack of • Protection of • Lack of
preserved • Lack of
•Disagreement on privacy reciprocity
• Data not found • resources guidelines
data use
Language barrier
• Restrictive data
format
• Technical
solutions not
available • Lack
of metadata and
standards

Legal Capacity-
Value
Trust and framework and building and
proposition and
transparency political effective tools
rewards
• Building trust advocacy for sharing
• Showing the
•Communication • Policy • Data
benefits and
and dialogue development and standardization
value of sharing •
political • System
Development of
commitment development
incentives
• Data • Training and
governance development of
agreements human resources

(Jussi Sane and Michael Edelstein, 2015)

In conclusion, the global health community already has resources available, and creating a global
framework for disease surveillance does not happen in a vacuum. When a perceived need is met
and the social, political, and cultural context is considered, data sharing in public health is
successful. There is a lot of exchange of public health data among subregional and regional
monitoring networks. The current networks should be incorporated into any global structure
since they frequently developed as a result of a particular local public health emergency. The
first step is always to make sure the person or organisation collecting the data is able and willing
to share it, regardless of the sharing channels.
References

Jussi Sane and Michael Edelstein (2015) ‘Overcoming Barriers to Data Sharing in Public Health A Global
Perspective’, Centre on Global Health Security [Preprint].

Peter Nsubuga, M.E.W.S.B.T.M.A.A.S.B.B.C.V.B.T.M.C.V.E.R.I.D.S.D.F.S.R.V.T.M.V. and M.Trostle. (2006)

‘Chapter 53Public Health Surveillance: A Tool for Targeting and Monitoring Interventions’, Disease
Control Priorities in Developing Countries. 2nd edition [Preprint].

Tulane University school of Public Health and Tropical Medicine (2023) ‘What Is Public Health
Surveillance?’, What Is Public Health Surveillance? [Preprint].

University of Cambridge (2023) ‘Health Surveillance’, Health Surveillance [Preprint].

WHO (2022) ‘Surveillance in Emergencies’, Emergencies [Preprint].

WHO (2023) ‘Importance of surveillance in preventing and controlling noncommunicable diseases

Publications by topic’, Non Communicable Diseases [Preprint].

Willem G van Panhuis, P.P.C.E.J.G.R.W.A.J.H.D.H.& D.S.B. (2014) ‘A systematic review of barriers to data
sharing in public health’, BMC Public Health [Preprint].