Malaria Control and Elimination - Malaria Monitoring, Evaluation and Surveillance

Monitoring and Evaluation (M&E) in Equatorial Guinea

The Bioko Island Malaria Control Project led by MCDI was awarded the Business Excellence Award for Performance Measurement in 2009 by the Global Business Coalition on HIV/AIDS, TB and Malaria in recognition of its strong integrated approach towards performance measurement. It recognized MCDI and the BIMCP for its use of state-of-the-art information technologies, such as the current use of tablets and cloud based systems, linked into a georeferenced database which enabled real-time and location-specific data collection, processing and analysis. It also recognized the use of new light-emitting diode (LED) light traps to maximize the number of mosquitoes trapped for entomological monitoring.

Learn more about our experience in Vector Control M&E.

Monitoring and Evaluation (M&E) in Benin

MCDI's USAID-funded ARM3 project in Benin worked to strengthen all major health information systems within the country, seeking to integrate the array of databases using a common platform, the District Health Information Software (DHIS2).

ARM3 also strengthened the capacity of local partners through an active M&E Working Group, which works to improve institutional support to existing information systems. The program also uses a performance improvement approach in health zones and hospitals.

An integrated Community Case Management (iCCM) mobile health application was created by MCDI, developed on the open-source CommCare software platform to support the implementation of activities. The application is designed to collect community health worker (CHW) data that can be viewed instantly on the internet. This platform allows validation conditions to be set to guarantee more accurate reporting.

MCDI assisted the Benin Ministry of Health in developing a data quality audit and supervision program which enhances the completeness, timeliness and accuracy in reporting. This has included annual reviews of Health Zone data; training workshops for statisticians from participating Departmental Health Directorates and personnel responsible for the management of information systems at the national level; support to the MOH in implementing supportive supervision visits of staff responsible for malaria data collection, entry and transmission

MCDI also effectively used a tablet-based open source data system for the PADNET research project in Benin. PADNET studied the durability and use of bed nets over time with field data collection carried out using tablets programmed by MCDI staff.

Other M&E Experience

Under the IMaD project led by MCDI, the information collected through OTSS visits to health facilities was used to target future supervision visits to underperforming facilities. The database containing the results of the OTSS visits was transferred to the host country governments as the basis for on-going monitoring, supervision and support.

Through MalariaCare's, continued implementation of OTSS, MCDI supports the improvement of diagnostic data collection systems to facilitate tracking and reporting on progress and to facilitate informed decision making.

Surveillance through Polymerase Chain Reaction (PCR) and Loop-mediated Isothermal Amplification (LAMP)

PCR and LAMP are techniques that are critical to achieving malaria elimination goals in pre-elimination and elimination settings. PCR is capable of detecting malaria parasites at levels well below the threshold that can be detected through microscopy or using currently available Rapid Diagnostic Tests (RDTs), including in pregnancy. LAMP is a simpler alternative to PCR.

Under MalariaCare, MCDI provided policy guidance and support to the Ministries of Health to support PCR capability building in pre-elimination zones of MalariaCare countries. PCR has been used by MCDI to validate MCDI’s WHO-compliant slide sets, and as the gold standard in assessing malaria microscopy competence.

In Equatorial Guinea, MCDI is introducing PCR for the detection of parasitemia in low transmission areas where a new malaria vaccine (PfSPZ manufactured by Sanaria Inc.) is being evaluated in clinical trials conducted with MCDI’s operational support under the Equatorial Guinea Vaccine Initiative. Quantitative PCR has also been used within the Bioko Island Malaria Control Program since 2004 for entomological monitoring purposes (i.e. for species identification, sporozoite analyses, and detection of markers for resistance to insecticides).