Monitoring Malaria Trends with Cell Phones and Site Visits in Ethiopia
Cell phones and supervisory visits are helping analyze malaria trends throughout Ethiopia’s Oromia region, and the related project was presented at the 61st American Society of Tropical Medicine and Hygiene annual meeting in November 2012. The presentation occurred during a U.S. Agency for International Development (USAID)-organized symposium titled, “Every Last Case: Innovations in Malaria Surveillance in Low-Income Settings.”
The project is a collaborative effort led by the Ethiopian Federal Ministry of Health, the Oromia Regional Health Bureau, Tulane University School of Public Health and Tropical Medicine, USAID/President’s Malaria Initiative (USAID/PMI), the Addis Continental Institute of Public Health, and MEASURE Evaluation. The project works by using Short Message Service (SMS) technology, or texts, to build on existing reporting systems in Ethiopia to monitor malaria diagnostic, treatment, and control activities. The SMS project began in late 2009, with data collection taking place in April 2010. The project is anticipated to end in October 2013.
Dr. Joshua Yukich, research assistant professor at Tulane, said the project also is timely because it corresponds with increasing need for improved malaria surveillance systems globally, due to heavy investments in primary malaria prevention from the Global Fund, USAID/PMI, and other donors. “Improving the quality and timeliness of malaria surveillance is an area of great interest globally,” he said.
By using mobile phones to communicate malaria case information in the Oromia region, data analysts can determine if malaria incidence rates are increasing in an area and then quickly communicate this issue to the other health workers in that area. The workers can use these data to increase their prevention efforts and ensure that drugs are fully stocked or take other steps to curb a potential epidemic. Health workers can also report drug stock outs and other needs via SMS. Reporting these concerns using cell phones means those in charge can receive the information faster and more promptly respond to these needs.
Yukich also noted the SMS system presents new challenges, including how to effectively communicate the large amount of gathered data to the health teams at all levels so the necessary actions can be taken. “The biggest challenge is taking a rich source of data and translating it into something useful for community health workers and getting it back to them rapidly,” he said.
The workers can then use this information for their own needs, such as making the case for more resources at their facilities or posts. The project also tries to ensure laboratory diagnostics quality by developing a quality assurance and control system to ensure data are appropriate and relevant for monitoring malaria trends.
The key thing is to “make sure results are communicated down as well as up,” Yukich said.