Using information systems to track a killer parasite

By John Miller, MACEPA Senior Technical Advisor

As a country wages a successful battle against malaria, transmission of the disease decreases and it becomes more difficult—and more time-sensitive—to find and treat the remaining cases. In this phase, our definition of success must shift from lives saved to cases detected. While less dramatic than earlier steps, this is an important step forward on the path to eliminating the disease. In order to accomplish this, dynamic systems must be put into place to facilitate the flow of quality data.

National surveys like the National Malaria Indicator Survey are great for the big picture but they don’t help you understand challenges well at the local level. Yet, as malaria is reduced focusing on transmission becomes more critical, and therefore it’s vital to have timely access to localized information—actionable intelligence, if you will. But consistent reliable data is a huge challenge in many countries.

Take Zambia, for example. I presented a poster during the Gates Foundation Malaria Forum today that highlighted the country’s experience implementing a malaria rapid reporting system to track malaria cases.

As with many countries in Africa, Zambia’s health system is overburdened and understaffed. Figures from health facilities trickle in near the end of every month, but it can be many more months before that information is organized and shared. To strengthen the system, the national malaria control program has established a rapid reporting system that records the same malaria data—17 indicators on cases, blood tests, and medicine stocks—on a weekly basis, and those details are sent to a server by inexpensive, basic mobile phones. Officials at all levels of the health system are then able understand and respond to malaria in real time.

The information collected, those 17 indicators, is available to decision-makers in a built-data dashboard of charts and graphs.  A health official simply refreshes the Exc

el file on their computer and they can view what’s going on in an area down to the community level. A district health information officer, for example, can see their own data and make informed decisions to better target limited resources and time.

As WHO Director-General Margaret Chan aptly stated during her keynote address at the forum today, “Good malaria surveillance means knowing where the enemy lies.” Thanks to rapid reporting, Zambia has the malaria parasite on the run and won’t stop until the disease has been eliminated. Zambia can be a model for others in the region.

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