Syndromic surveillance for governance in health emergencies and disaster risk management in the Philippines

The thesis describes the use of syndromic surveillance in the Philippines to analyze health impacts inflicted by climatological, hydrological, meteorological hazards, and complex emergencies for the enhancement of hazard risk reduction. The thesis looks at two systems, an established syndromic surveillance for disasters, Surveillance in Post Extreme Emergencies and Disasters or SPEED, and a routine health information system, eHealth Tablet for Informed Decision Making of Local Government Units or eHATID LGU. First, the thesis describes the trends observed in SPEED in terms of syndromes and diseases in health facilities, age groups, and time periods seen in the aftermath of disasters in 2013. Second, the thesis looks at eHATID LGU trends in diseases seen across 2016 in a municipality in the Philippines and their relation to weather variables. This is a pilot demonstration of the use of routine health information systems to monitor and analyze climate-sensitive diseases. Lastly, the thesis discusses the governance implications of the use of health information systems for decision-making in research areas such as health emergency and disaster risk management (H-EDRM) and climate resilient health systems. The first section (Introduction) gives an overview of the different frameworks used in disease surveillance, H-EDRM, and climate resilient health systems. This section introduces syndromic surveillance and different examples of its use in different countries. It also gives the specific objectives of the thesis. The second section (Methods) gives the different analytical methods and indicators used to describe the two databases, SPEED and eHATID LGU. The third section (Results) describes the output of the statistical analysis of the databases. It is divided into four subsections: (1) SPEED in three natural hazards in 2013, (2) SPEED in typhoon Haiyan, (3) SPEED in the Zamboanga armed conflict, and (4) eHATID in San Jose de Buenavista, Antique. The fourth section (Discussion) describes the implications of the results of the study to common diseases in disasters, deaths in disasters, trends across time, health facilities used, health systems resilience, correlation with weather data, limitations, health information system use, research, and policy