Cost-effectiveness analysis of the IDSP project at Kannur district of north Kerala

How to cite this article:
Borker S, Venugopalan PP. Cost-effectiveness analysis of the IDSP project at Kannur district of north Kerala. Ann Trop Med Public Health 2012;5:623


How to cite this URL:
Borker S, Venugopalan PP. Cost-effectiveness analysis of the IDSP project at Kannur district of north Kerala. Ann Trop Med Public Health [serial online] 2012 [cited 2017 Nov 14];5:623. Available from:


The Integrated Disease Surveillance Project (IDSP) was started in Kannur district of north Kerala in Feb 2006, inspite of the parallel programs for communicable and non-communicable diseases being run in the district. We tried to evaluate whether IDSP was really necessary in the district. The author tried to compare the cases detected and the deaths of four major communicable diseases in the district before and after (3 years) the launch of the IDSP. The data was obtained from the District medical officer’s office. We also compared this data with the total funds utilized by the district for IDSP purposes.

The results of the study are as follows: [Table 1] and [Table 2].

Table 1: Cases and deaths in Kannur before and after IDSP launch
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Table 2: IDSP fund utilization
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By applying Wilcoxan’s sign rank test to the table

For cases before and after IDSP, Z = -7.30; P-value = 0.465 (not statistically significant)

For deaths before and after IDSP, Z = -0.535; P-value = 0.593 (not statistically significant)

Therefore, there is no statistically significant change in cases reported and deaths reported before and after the launch of the IDSP. [Table 1] also shows that deaths due to leptospirosis amounted to 75% of all the deaths in Kannur. The authors on investigation found that leptospirosis cases remained unsuspected which caused a delay in diagnosis, hence the mishap.

Therefore, a total of Rs. 1,519,286 was used by the IDSP after its launch. Most was spent on consultants and training, which exceeded the allocated figure. Therefore, to save eight people from dying, the district had spent Rs. 1,519,286. Is it worthwhile in our settings? [Table 2] thus states the inappropriate fund utilisation at Kannur.

We do agree with the statement that IDSP is indeed a key step for strengthening surveillance in our country, [1] and that this project will improve public health in our country, but this unique study rightfully states another picture. This project is designed for India as a whole, and, as we are all aware Kerala, is well known for its best health indicators in the whole Nation; thus, such an isolated not cost-effective study regarding IDSP project may give a false projection, but, if left unpublished, may invite a publication bias. More such cost-effectiveness studies regarding IDSP should be done all over India so that adequate resource utilization can take place in a resource-poor country.



1. Thakur JS. Integrated disease surveillance – A key step to improve public health in India. Indian J Community Med 2006;31:4.

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.109339


[Table 1], [Table 2]

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