Nikhil Tandon, Rajib Dasgupta, Faruqueuddin Ahmed, Narendra K. Arora, Rakesh Kumar, Prashant Mathur, Shikha Dixit, Rakesh Gupta, Mayur Vaswani, Rakesh K. Singh, Natasha J. Howard, Atiqur Rahman, Sanjay Chaturvedi, Jaishri Jethwaney, Manoja Kumar Das, Rajendra Prashad, Suresh Dalpath, Laurette Dubé, Mark Daniel, Dixit, Shikha, Arora, Narendra K, Rahman, Atiqur, Howard, Natasha J, Singh, Rakesh K, Vaswani, Mayur, Das, Manoja K, Ahmed, Faruqueuddin, Mathur, Prashant, Tandon, Nikhil, Dasgupta, Rajib, Chaturvedi, Sanjay, Jethwaney, Jaishri, Dalpath, Suresh, Prashad, Rajendra, Kumar, Rakesh, Gupta, Rakesh, Dube, Laurette, and Daniel , Mark
Background: Inadequate administrative health data, sub-optimal public health infrastructure, rapid and unplanned urbanisation, environmental degradation and poor penetration of information technology make the tracking of health and wellbeing of the populations and their social determinants in the developing countries challenging. Technology integrated comprehensive surveillance platforms have thepotential to overcome these gaps. Objective: The manuscript provides methodological insights into establishing a geographic information system (GIS) integrated, comprehensive surveillance platform in rural North India, a resource constrained setting. Methods: The INCLEN (International Clinical Epidemiology Network) Trust International established a comprehensive SOMAARTH Demographic, Development and Environmental Surveillance Site (DDESS) in rural Palwal, a district in Haryana, North India. The surveillance platform evolved through adopting four major steps: 1) site preparation 2) data construction 3) data quality assurance 4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geospatial data construction. Surveillance data architecture was built upon the geo spatial land parcel data sets.Dedicated software (SOMAARTH-1 ) was developed for handling high volume of longitudinal data sets.The built infrastructure data pertaining to the land use, water bodies, roads, railways, community trails,landmarks, water, sanitation and food environment, weather and air quality, and demographiccharacteristics were constructed in a relational manner. Results: The comprehensive surveillance platform encompassed 0.2 million population residing in 51 villages over a land mass of 251.7 sq. Km having 32,662 households and 19,260 non-residential features(cattle shed, shops, health, education, banking, religious institutions etc.). All the land parcels were assigned geo-referenced location identification numbers to enable space and time monitoring.Subdivision of villages into sectors helped in identifying socially homogenous community clusters (61.8%of 676 sectors). Water and hygiene paramenters of the whole area were mapped on the GIS platform and quantified. Risk of physical exposure to harmful environment (poor water and sanitation indicators)was significantly (P .001) associated with the caste of individual household and the path was mediated through socio-economic status and density of waste spots (liquid and solid) of the sector in which these households were located. Ground-truthing for ascertaining the land parcel level accuracies, community involvent in mapping exercise and identification of small habitations not recorded in in the administrative data were key learnings. Conclusion: The SOMAARTH DDESS experience allowed to document and explore dynamic relationships,associations and pathways across multiple levels of the system i.e., individual, household, neighborhood and village through a geospatial interface. This could be used for characterization and monitoring of awide range of proximal and distal determinants of health of the households. Refereed/Peer-reviewed