Health ... Malaria
ASTMH (American Society of Tropical Medicine and Hygiene)

Title: Evaluation of a mobile phone-based malaria routine surveillance system in Amhara Region, Ethiopia

Burgess COMMENTARY

Peter Burgess

Session: Poster Session B Presentations and Light Lunch Abstract Number: 974 Title: Evaluation of a mobile phone-based malaria routine surveillance system in Amhara Region, Ethiopia Presentation Start: 10/27/2015 12:00:00 PM Presentation End: 10/27/2015 1:45:00 PM Authors: Asefaw Getachew1, Jeff Bernson2, Belendia Serda1, Berhane Tesfay1, Asnakew Yeshiwondim1, Adem Ahmed1, Belay Beyene3, Callie Scott2, Caterina Guinovart2, Rick Steketee2 1 PATH, Addis Ababa, Ethiopia, 2 PATH, Seattle, WA, United States, 3 Amhara National Regional State Health Bureau, Bahir Dar, Ethiopia

Abstract: Ethiopia is a malaria epidemic-prone county learning to transition across the control to elimination continuum in selected districts. Surveillance systems for tracking morbidity and monitoring systems to decide on positioning of anti-malaria commodities based on village level spatiotemporal fluctuations are crucial parts of the program. A rapid reporting system was established in health posts (HPs) in 209 villages in eight districts in Amhara Region, Ethiopia. Community based surveillance assistants (CBSAs) were trained and deployed to report weekly morbidity and commodity data using mobile phones supported by the web-based DHIS2 platform. Reporting includes the counts of seven morbidity and behavioral elements and six commodity data elements. Weekly reporting data were extracted over a 20-month period (September 2013-April 2015). We explored whether reported surveillance data could enable health workers to visualize accurate data to follow the oscillation of morbidity and trigger local response decisions. Across the 209 HPs, the overall report submission rate was 91%; 89% of submitted data was considered complete; and 89% of HPs reported data parameters free of errors. Due to challenges with the DHIS2 system, mobile reporting timeliness could not be captured in the system. In the 209 HPs, the mean weekly rapid diagnostic test (RDT) positivity rate was 30% (weekly range: 13-49%). This initial system assessment demonstrated that for the existing data collection system in rural Ethiopia, it is feasible to use smartphones to report from rural HPs into platforms such as DHIS2 to inform decisions at any level. Data validation procedures are critical to assess and ensure the accuracy of data reported. Factors influencing data quality include the training and follow-up of the CBSA in each HP catchment area, existence and use of job aides, and the number and quality of source documents for reporting cases. Lessons were documented on specific improvements to the rapid reporting system including better measurements of reporting timeliness.