Basse Health and Demographic Surveillance System

By virtue of the size of the population it covers, the Basse HDSS offers opportunities to understand the dynamics and risk factors associated with common infectious diseases prevailing in a typical Sub-Saharan African setting characterised by poverty and limited access to health care facilities and services. Prospective follow up of the population through 4-monthly household demographic (and biennial socio-economic) updates determines the trends in the death rate in different age groups of the population; and the conduct of verbal autopsies for as many deaths as possible ascertains the probable causes of death. The process therefore enhances our understanding of the health and socio-economic factors that that drive and sustain the determinants of disease-specific morbid episodes and mortality, especially infectious diseases among children.

The Basse Health and Demographic Surveillance System (BHDSS) was established in July 2007, primarily to support Basse’s participation in the Global Enteric Multicentre Study (GEMS) and the ongoing Pneumococcal Surveillance Project (PSP). It covers a population of about 170,000 in 219 settlements in the Fulladu East and Kantora Districts of the Upper River Region of The Gambia, a setting typical of much of rural Sub-Saharan and with a high burden of communicable and preventable diseases. In addition to the GEMS and PSP projects, it hosts and facilitates the implementation of a range of other projects and studies.
The BHDSS, with a similar operational design as the Farafenni HDSS, constitutes a potential valuable resource to establish benchmarks and monitor progress towards the achievement of post-2015 global and regional health indicators that the international community will be expected to set.
Specific strategies to be adopted to maximise the scientific output of the BHDSS include:
• Potential linkage of DSS data with Basse Major Health Centre records (in recognition of its potential upgrading to a District Hospital), thus broadening the scope for medical research to include, among other things, disease-specific morbidity burden estimation for both communicable and non-communicable diseases, and their respective impact on quality of life.
• Enhance capacity to support the placement of PhD students in the fields of Demography, Epidemiology, Sociology, etc, and build multi-disciplinary capacity for optimal utilisation of the data generated by the platform.
• Fully engage government stakeholders in the utilisation of the platform database to inform public health policy formulation and review; as well as generating the necessary evidence base required to guide rational health care delivery planning and resource allocation.