ESTABLISHMENT OF HOSPITAL SURVEILLANCE UNITS (HSU) IN THE PHILIPPINES

1. Background and Rationale

a. The A. 3573 is the Republic Act 3573 which is the law on reporting of communicable
diseases. It requires all individuals and health facilities to report on notifiable diseases to
local and national health authorities.
b. The IHR 2005 is the International Health regulations (2005), state parties are required to
carry out an assessment of public health events arising in their territories utilizing a
decision instrument, and to notify WHO of all qualifying events within 24 hours of such
an assessment. The seven areas of work for IHR (2005) implementation: Foster global
partnerships, strengthen national disease prevention, surveillance, control and response
systems, strengthen public health security in travel and transport, strengthen WHO
global alert and response systems, strengthen the management of specific risks, sustain
rights, obligations and procedures, and conduct studies and monitor progress.
c. There is no existing policy for the establishment of Hospital Surveillance Units noted
during the course of review of the DOH intranet. But other policies/administrative
orders related to disease surveillance and reporting are noted:
i. Executive Order No. 352 (s. 1996) "Designation of Statistical Activities that will
generate critical data for decision-making of the government and private sector”
ii. Joint Memorandum of Department of Interior and Local Government and
Department of Health circular 3 (s. 1997) "Enjoyed all Local Government Units
to submit health reports according to previously prescribed guidelines and
format until modified and revised "
iii. Republic Act 3573 (Law of Reporting of Communicable Diseases) requires all
individuals and health facilities to report notifiable diseases to local and national
health authorities.
iv. Administrative Order No. 2005-0023 (Implementing Guidelines for Fourmula
One for Health as Framework for Health Reforms), Section C2.c.iii, states that:
"Disease surveillance shall be intensified to ensure that the targets for disease
elimination, prevention and control are attained".
2. Scope and Coverage
a. The issuance applies to all DOH retained, specialty hospitals and private hospitals. How
about other facilities like Rural Health Units, District Hospitals etc.?
b. What is the basis/rationale for selecting what hospitals to be covered by the issuance?
3. Core functions of the HSU
a. When will be the reporting of the notifiable diseases takes place? After the
initial/provisional diagnosis or after the confirmation of the disease?
b. Is there an existing mechanism/process made when there is a change in the diagnosis of
the case?
c. Please clarify item number five: If with training to Frontline FETP:
4. Organizational Structure
a. Under section C, there would be a better/more efficient reporting mechanism if we
would include the respective ward or section manager (chief nurse) among the HSU
staffs.
 b. Under section D, they should closely coordinate with all hospital wards/areas like the
surgery, neurology ward. The Central laboratory should also be consulted for proper
specimen collection and case confirmation.
5. Under C1, the nurse surveillance officer should coordinate and facilitate disease surveillance to
all hospital wards and departments.
6. The HSU Medical Officer should also coordinate with other HSU medical officers of other
hospitals and represent his/her hospital during inter-hospital meetings.
7. Under C3 bullet number 5, please include the department of Surgery, Emergency room and OPD
as well.
8. Under C3, the nurse surveillance coordinator should also conduct a regular or random review of
different hospital departments to check if the hospital staffs are following/reporting the
notifiable diseases accurately.
9. Under C4, the HSU encoder should also ensure the completeness of the data on the data
management system.
10. The budget and funding heading can be revised to Resource Management to completely
encompass all the succeeding topics under it. The section discussed different resources needed
in order to establish an HSU like human resource, information and communication technology,
laboratory equipment etc. and not merely budget and funding.
a. Under human resource, the HSU staff should undergo pre-employment training to
orient them to the different functions of the HSU and to make them competent before
they commence to their work.
b. Under information and communication technology, who will provide the HSU software?
c. Under transportation, ideally a dedicated vehicle should be assigned for specimen
transport and what are the requirement/specifications for the transport vehicle.