Abstract
BackgroundIn Mozambique, malaria is the principal cause of morbidity and mortality. Efforts are being made to increase control activities within communities. These activities require management decisions based on evidence of malaria incidence. Although some data generated are of poor quality, there is little research towards improving the reporting systems.MethodsAn analysis of the quality of routine malaria data was performed in selected districts in Southern Mozambique from August to September 2003.The aim was to assess the quality of the source data in terms of completeness, correctness and consistency across management levels.ResultsAnalysis revealed primary data to be of poor quality. The diversity of reporting systems with limited coordination give rise to redundancies and wastage of resources.There was evidence of "invention" of data in health facilities contributing to an incorrect representation of malaria incidence. Large, "non-clinical", time-based variations of malaria cases due to reporting delays were also noted, contributing to false alerts of outbreaks.Furthermore, targets established in the national strategic plan for malaria cannot be calculated through the existing systems; this is the case, for example, for data related to pregnant women and children under-five years.Discussion and recommendationsThe existing reporting system for malaria is currently not satisfying the information needs of managers. It is suggested that one standardized system, including the creation of one form to include the essential variables required for the calculation of key indicators by age, gender and pregnancy status, and to establish a national database that maps malaria by location.
Highlights
In Mozambique, malaria is the principal cause of morbidity and mortality
Targets established in the national strategic plan for malaria cannot be calculated through the existing systems; this is the case, for example, for data related to pregnant women and children under-five years
Information systems can support the management of malaria programmes by: (a) drawing malaria density maps by health area according to different targets and (b) by estimating the number of children under-five years of age living in malaria areas by health facility catchments area, as well as by district or province, allowing rational planning based on evidence
Summary
Efforts are being made to increase control activities within communities. These activities require management decisions based on evidence of malaria incidence. The estimated cost of malaria, in terms of strains on health systems and economic activity lost, are enormous. In 1997 an estimated US$1.8 to $2 billion was spent in Africa on both direct costs of malaria (prevention and (page number not for citation purposes). Malaria Journal 2004, 3 http://www.malariajournal.com/content/3/1/3 care) and on indirect costs (such as lost of productivity or income with illness or death). This figure was projected to rise to US$3.6 billion or more by end of 2000 [3]. The burden is greatest among children under five years of age and amongst pregnant women [4,5]
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