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Epidemiology: Monitoring and Evaluation

Definition of ‘Monitoring’:
Monitoring is the performance and analysis of routine measurements aimed at detecting changes in the environment or health status of the population.
Monitoring can be of variety of activities like:
• Health program
• Air quality
• Water quality
• Intrauterine growth
• Nutritional status
• Functioning of a health facility etc.

Definition of ‘Surveillance’:

Surveillance is the continuous scrutiny of the factors that determine the occurrence and distribution of disease and other condition of ill health.
It is keeping a watchful eye on select diseases and health related events in the population, so as to timely detect any increase or decrease of the health problem or quickly identity a new emerging problem
Types of surveillance:
• Active surveillance
• Passive surveillance and
• Sentinel surveillance

Differences between Monitoring and Surveillance:


  1. It is a management tool
  2. Periodic collection and analysis of indicators
  3. To detect deviation from the established practice
  4. Wider scope, as it can be done form many programs by trained staff, once the indices for monitoring are developed
  5. Periodical routine reports and field visits
  6. Usually concerns specific group or individuals who are the performers in the program
  7. This can be done by trained technicians and automated gadgets
  8. Monitoring is a part of surveillance


  1. It is an epidemiological tool
  2. Continuous collection and analysis of health events
  3. To monitor trends, incidence, prevalence, geographical spread, outbreaks
  4. Limited to a few diseases of national significance
  5. Routine reports (monitoring data), surveys and special studies, case investigations, census are a part of surveillance
  6. Usually concerns populations, like trend of disease in the population
  7. Requires analysis and interpretation of data by professional epidemiologists
  8. It is a broader concept

Tiwari P. Epidemiology Made Easy. New Delhi: Jaypee Brothers; 2003
Gordis, L. (2014). Epidemiology (Fifth edition.). Philadelphia, PA: Elsevier Saunders.
Bonita, R., Beaglehole, R., Kjellström, T., & World Health Organization. (2006). Basic epidemiology. Geneva: World Health Organization.
Schneider, Dona, Lilienfeld, David E (Eds.), 4th ed. Lilienfeld’s Foundations of Epidemiology. New York: Oxford University Press; 2015
K. Park. Principles of Epidemiology and Epidemiologic Methods. In Park’s Textbook of Preventive and Social Medicine. 24th Ed. Jabalpur: Banarasidas Bhanot, 2017: pg 58 – 145

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Steps in Investigation of an Epidemic:
Tests of Significance:
Monitoring and Evaluation:
Advantages and Disadvantages of Case Control Studies:
Advantages and disadvantages of cohort study:
Basic Concepts in Epidemiology:
Types of Epidemiological Studies:
Differences between Case – control and cohort study:
Uses of epidemiology:
Blinding in Experimental Studies:
Evaluation of a Screening Test: