Introducing regular behavioural surveillance into the health system in India: Its feasibility and validity.

ABSTRACT

Background. Illness is affected by human behaviour. However, in most developing countries the risk behaviour of the general population is not assessed. We developed a surveillance system to assess the ‘risk factors’ at the community level using the routine healthcare system. Methods. The Comprehensive Rural Health Services Project at Ballabgarh, Haryana, provides healthcare to a population of 82 933 through 2 primary health centres and 24 health workers. Information on behavioural risk factors for communicable and non-communicable diseases was collected by health workers during the annual health census from December 2003 to February 2004. The information collected pertained to maternal and child health, and household and individual behaviour. We compared the data related to individual behaviour with that of a survey of non-communicable diseases risk factors done in the same area. Results. Data were collected from (i) mothers who had delivered during the preceding year (n=1625), (ii) a random sample of individuals (n=2865), (iii) and all households (n=7488). The response rate was 85% for mothers, 91% for households and 95% for individuals. Approximately 80% of the households had access to drinking water, 32% to sanitary latrines, 28% of women increased their dietary intake during pregnancy, and 50% of adult men used tobacco. Comparing these results with those from the survey of risk factors for non-communicable diseases revealed no significant differences. Conclusion. It is feasible for health workers to do behavioural surveillance by using the routine healthcare system.