Strategy 1 – Harmonisation of health data needs and development of adequate surveillance systems, including operational research
To monitor health programmes and to undertake diseases surveillance development-aid agencies request health information from the Pacific island countries and territories on a systematic basis. However there is currently little consultation or integration between these agencies, resulting in the multiplication of data requests while human and financial resources are often limited especially in some remote areas.
As part of the effort to deal with these problems, the Pacsel method has been proposed to reduce the pressure on data providers thus improving the quality of the health information provided.
This method uses a list of weighted criteria differentiated between communicable diseases and health indicators. The Pacsel method scores either category, thus allowing ranking according to their public health importance–prioritising the ones for which surveillance activities are useful.
The PHS&CDC section undertakes operational research related to the control and prevention of communicable diseases. Currently a study has been initiated to determine the working conditions in the field for a rapid dengue test. This colorimetric test produced by an Australian compagny allows practicians to know if a patient is infected by a dengue virus in a few minutes. Preliminary results are awaited in a few months.
Strategy 2 – Development of relevant computer applications
The software Epi INFO is very suitable for use in surveillance work. As it is a public domain shareware promoted by both WHO and CDC, the previous version of Epi INFO have been quite popular amongst computer-literate health professionals. This, together with the fact that it enables discussion groups to solve problems and share hints via e-mail, makes it an excellent tool for use in data analysis and report making.
In addition Epi INFO has been central to the preparation of training materials in surveillance, which is the subject of Strategy 3. Training issues have been brain-stormed with the professionals involved in the European Programme for Intervention Epidemiology Training (EPIET) and the French surveillance network in Paris, resulting in the outline of a training module focusing on basics in surveillance and use of Epi INFO 6.
Strategy 3 – Adaptation of field epidemiology and public health surveillance training programmes to local and regional needs
Since 1996, the Pacific Island countries and territories and the Pacific-rim networking universities reached a general consensus on training opportunies. These are focused on field epidemiology and disease and public health surveillance for key mid-level health professionals.
The strategy aims to reach a critical number of Pacific public health agent to ensure the establishment and the sustainability of a regional disease surveillance system. The PHS&CDC section undertakes regional training programmes in public health surveillance and use of Epi INFO.
Besides, a consultancy has been performed to identify a framework for the development of modular training based on the networking of available training institutions and organisations in the Pacific. This resulted in proposals for a regional distance education project.
Strategy 4 – Promoting the use of e-mail, opening the network to new partners, new services and other networks
In the case of epidemics, using an early warning system allows information to travel faster than diseases. Electronic mail is perceived as the ideal, most sustainable tool to be used. Indeed, e-mail reduces communication costs as compared to fax and phone calls.
April 1997 saw the launch of a list-server called PACNET for the purpose of easy dissemination and sharing of information. Since then, early warning and update messages on epidemics have been posted on PACNET.
In December 1998, the first Pacific Telehealth Conference was organised in Noumea. This melting-pot event signed the first partnership between two regional Pacific health network: PACNET and the Western Pacific Health Net which is coordinated by the Pacific Basin Medical Association. Among other themes, the establishment of a joint website was discussed. Links with other regional networks like ProMED and the CDC Epi INFO listserver will be sought.
Strategy 5 – Publications
This fifth strategy consists in the publication of timely and accurate health information, including:
A monograph on public health surveillance in the Pacific was released in July 1998 to describe the background on which the PPHSN network was established.
A quarterly bulletin called Inform’Action was launched in October the same year to replace the monthly SPEHIS report (South Pacific Epidemiological and Health information Service).