Publications

Publications

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PMI Measure Malaria End-of-Project ReportPMI Measure Malaria2023English, , TR-23-625
Identifying Quality Constraints of Inpatient Data in U.S. President’s Malaria Initiative Partner CountriesPMI Measure Malaria2023English, , , Quality inpatient data, specifically for severe malaria and malaria mortality, are essential for understanding the true burden of the disease in malaria endemic countries and for enabling decision makers to provide effective and contextual responses to the gaps and challenges observed in their countries. Inconsistencies in reporting practices and interpretation of cases, including misclassification, overestimation, and underreporting, are among observed challenges in the quality of inpatient data in U.S. President’s Malaria Initiative (PMI) Measure Malaria (PMM) countries. A review of the published and grey literature and key informant interviews with PMM surveillance, monitoring, and evaluation (SME) advisors and national malaria control program (NMCP) stakeholders informed the findings presented in this synthesis. The literature suggests that inpatient malaria data are not consistently and routinely reported, thereby complicating the estimation of malaria trends and use in making programmatic decisions. Instead, inpatient data may be used to understand the clinical manifestations of severe malaria, to study case management and quality of care, and to examine the causes of hospital deaths and the quality of hospital cause of death data. Interviews with PMM SME advisors and country stakeholders also confirm the challenges in the quality of inpatient data, which they attribute to diverging reporting practices and differences in reported data, especially in the data coming from a lower level compared to the data reported at the national level.TR-23-517 PMM
A Guide for Developing Data Dictionaries to Streamline Data Analysis, Use, and InterpretationPMI Measure Malaria2023English, , The guide will support the U.S. President’s Malaria Initiative (PMI) Measure Malaria (PMM) countries to create, own, and implement a standardized process of developing, maintaining, and updating a country-specific data dictionary. The process will include defining, reviewing, revising, and updating (as needed) the routine health information system data structure, indicators, data elements, and points of disaggregation. This guide will clarify the processes and protocols for creating a new data dictionary or updating an existing one and supporting its accessibility to a broad spectrum of users at national, subnational, and facility levels.MS-23-217 PMM
Indice d’information sur le paludisme : Définition des échelles de mesurePMI Measure Malaria2023French, , , , L’indice d’information sur le paludisme (Malaria Information Index en anglais, ou MII) est un cadre de mesure de l’état des composants de surveillance, de suivi et d’évaluation (SSE). Il a pour but de fournir des mesures internes pour faciliter l’approche de collaboration, d’apprentissage et d’adaptation de PMI Measure Malaria (PMM) tout au long du cycle de vie du projet. Also available in English. Indice d’information sur le paludisme : Guide de l’utilisateur et aperçu Indice d’information sur le paludisme : classeurMS-23-220b-FR
Malaria Information Index: Measurement Scale DefinitionsPMI Measure Malaria2023English, , The Malaria Information Index (MII) is a framework for measuring the status of components of surveillance, monitoring, and evaluation (SME). The MII was created to provide internal metrics to help PMI Measure Malaria (PMM) collaborate, learn, and adapt as an organization throughout the project life cycle. This resource provides measurement scale definitions. Also available in French. More MII Resources: Malaria Information Index Overview and User Guide Malaria Information Index WorkbookMS-23-220b
Indice d’information sur le paludisme : Guide de l’utilisateur et aperçuPMI Measure Malaria2023French, , , , L’indice d’information sur le paludisme (Malaria Information Index en anglais, ou MII) est un cadre de mesure de l’état des composants de surveillance, de suivi et d’évaluation (SSE). Il a pour but de fournir des mesures internes pour faciliter l’approche de collaboration, d’apprentissage et d’adaptation de PMI Measure Malaria (PMM) tout au long du cycle de vie du projet. Les données du PMM seront utilisées par MII, entre autres : • pour faire le suivi des indicateurs du projet et documenter les résultats obtenus dans les pays selon le plan de suivi, d’évaluation et d’apprentissage (SEA) • pour identifier les occasions d’apprentissage ou de collaboration interne pour le projet • pour identifier les priorités dans la planification des travaux Fondé sur le même modèle que celui des Étapes d’amélioration continue et de Maturité de l’Interopérabilité des SIS (Systèmes d’information de santé) de MEASURE Evaluation, le MII met en œuvre une échelle de 3 à 5 points sur 18 composants organisés en 6 domaines. Ces composants permettent d’obtenir un aperçu de l’état des systèmes SIS et SSE au niveau national dans les pays participant au projet. L’échelle inclut également des mesures de la qualité des données et des éléments d’utilisation des données permettant d’identifier les changements dans la performance des systèmes SIS et SSE en matière de paludisme. Les applications annuelles du MII permettent de mieux comprendre les changements progressifs de l'état du système SSE contre le paludisme et peuvent être utilisées tout au long de la durée de vie d'un projet pour comprendre ses contributions potentielles au renforcement des performances de ces systèmes. Also available in English. Indice d’information sur le paludisme : classeur Indice d’information sur le paludisme : Définition des échelles de mesureMS-23-220a-FR
Malaria Information Index Overview and User GuidePMI Measure Malaria2023English, , , , , The Malaria Information Index (MII) is a framework for measuring the status of components of surveillance, monitoring, and evaluation (SME). The MII was created to provide internal metrics to help PMI Measure Malaria (PMM) collaborate, learn, and adapt as an organization throughout the project life cycle. Some of the ways PMM has used data from the MII include: • To track project indicators and document achieved results in countries according to the project’s monitoring, evaluation, and learning (MEL) plan • To identify opportunities for project learning or internal collaboration • To identify work-planning priorities Rooted in the same logic as MEASURE Evaluation’s health information systems (HIS) Stages of Continuous Improvement and HIS Interoperability Maturity models, the MII applies a scale that spans from 3 to 5 points to 18 components organized into 6 domains. These components provide a holistic picture of malaria HIS and SME system status at the national level in project countries. The scale also includes measures of data quality and data use elements to measure changes in the performance of malaria HIS and SME systems. Annual applications of the MII provide an opportunity to understand the incremental changes in malaria SME system status and may be used over the life of a project to understand its potential contributions to strengthening the performance of those systems. Also available in French. More MII Resources: Malaria Information Index Workbook Malaria Information Index: Measurement Scale DefinitionsMS-23-220a
Indice d’information sur le paludisme : classeurPMI Measure Malaria2023French, , , , , , , Créé par le projet PMI MEASURE Malaria, l’indice d’information sur le paludisme (Malaria Information Index, ou MII) est conçu pour mesurer l’état et la progression d’un ensemble complet de composants des systèmes d’information de santé (SIS) sur le paludisme, qui permettent de renseigner la planification des efforts de collaboration, d’apprentissage et d’adaptation (CAA). Le MII présente diverses applications, notamment : 1. Le suivi des indicateurs du projet et la documentation des résultats obtenus selon le plan de suivi, d’évaluation et d’apprentissage (SEA) 2. L’identification des occasions d’apprentissage ou de collaboration interne pour le projet 3. L’identification des priorités de planification des travaux L’indice d’information sur le paludisme mesure l’état de systèmes d’information qui contiennent des données pertinentes pour la surveillance, le suivi et l’évaluation (SSE) du paludisme au cours de cinq étapes. Il fournit un cadre pour comprendre les progrès accomplis dans le renforcement des procédés, structures et capacités en matière d’information sur le paludisme dans les pays, reposant sur les données disponibles. Ce classeur est constitué d’une échelle de mesure et d’un outil de collecte de données. L’échelle présente 18 éléments liés à l’information sur le paludisme, classés en six domaines, et définit les attributs de chaque composant sur une échelle à trois ou cinq points. L’échelle comprend également des mesures de la qualité des données et de leur utilisation, qui correspondent aux indicateurs de résultats de qualité et de gestion des données. Le MII a été pensé sous forme d’outil de projet interne pour la mesure de l’état et de la progression du paludisme dans chaque pays, mais il permet également d’apporter du contexte et des informations aux efforts du projet en matière de CAA. Il n’a pas été conçu comme un outil d’évaluation participative ou de comparaison des scores entre pays. Il est toutefois possible de partager à titre informatif les résultats des évaluations de cet indice avec les parties nationales concernées, notamment les programmes de santé nationaux de contrôle du paludisme ou les équipes nationales de la President’s Malaria Initiative (Initiative présidentielle contre le paludisme, ou PMI) des États-Unis. Also available in English. Indice d’information sur le paludisme : Guide de l’utilisateur et aperçu Indice d’information sur le paludisme : Définition des échelles de mesureMS-23-220-FR
Malaria Information Index WorkbookPMI Measure Malaria2023English, , , , , , The Malaria Information Index (MII), created by the PMI MEASURE Malaria project, was created to measure the status and progress of a comprehensive set of malaria health information system(s) (HIS) components that can be used to inform collaborating, learning, and adapting (CLA) planning. MII uses may include: 1. Tracking of project indicators and documentation of associated results according to the project's monitoring, evaluation, and learning (MEL) plan 2. Identification of opportunities for project learning or internal collaboration 3. Identification of work-planning priorities The MII measures the status of information systems that contain data relevant to malaria surveillance, monitoring, and evaluation (SME) across five stages. It provides a framework for understanding the progress toward strengthening malaria information processes, structures, and capacities in countries based on available information. This workbook consists of a measurement scale and a data collection tool. The scale outlines 18 components related to malaria information within six domains and defines attributes of each component on a five-point scale. The scale also includes measures of data quality and data use, which map to outcome-level indicators for data quality and management. The MII was designed for use as an internal project tool to measure status and progress in each individual country and context and to inform the project's CLA efforts. The index was not designed as a participatory assessment tool or to be used to compare scores across countries. However, results from the index assessments may be shared with country stakeholders such as the National Malaria Control Programs or the U.S. President's Malaria Initiative (PMI) country teams for informational purposes. Also available in French. More MII Resources: Malaria Information Index Overview and User Guide Malaria Information Index: Measurement Scale DefinitionsMS-23-220
Amélioration des compétences des prestataires et des superviseurs pour l’utilisation des outils de collecte des services de gestion, de suivi et d’évaluation du programme de lutte contre le paludisme en Côte d’IvoirePMI Measure Malaria2023French, , , , Le projet Measure Malaria (PMM) est financé par le programme President’s Malaria Initiative (PMI) de l’Agence des États-Unis pour le développement international (USAID). Son objectif principal est de soutenir le renforcement du système d’information sanitaire de routine (SISR) et de la surveillance, du suivi et de l’évaluation (SSE) du paludisme dans les 20 districts sanitaires de la Côte d’Ivoire soutenus par l’USAID. S’appuyant sur les leçons apprises et les réussites du projet MEASURE Evaluation de l’USAID dans la mise à l’échelle des modèles et des approches d’information sanitaire basées sur internet, le projet PMI Measure Malaria a amélioré la capacité des prestataires, superviseurs du niveau central et équipes-cadres de région et de district à mener des évaluations et analyses de la qualité des données à l’aide de tableaux de bord pour la revue électronique et les activités d’évaluation et d’analyse de la qualité des données au niveau des structures sanitaires. Ceci permettra aux gestionnaires des services de santé et prestataires de soins de développer des plans d’action pour résoudre les problèmes de qualité des données et d’accès à l’information sanitaire.fs-23-621-FR PMM
Improving Provider and Supervisor Skills on Data Management, Monitoring, and Evaluation for Malaria Services at the Malaria Control Program in Côte d’IvoirePMI Measure Malaria2023English, , , , , PMI Measure Malaria (PMM) is funded by the President's Malaria Initiative (PMI) of the United States Agency for International Development (USAID). Its main objective is to support the strengthening of the Routine Health Information System (RHIS) and malaria surveillance, monitoring, and evaluation (SME) in the 20 USAID-supported health districts of Côte d'Ivoire. Building on the lessons learned and successes of USAID's MEASURE Evaluation project in scaling up web-based health information models and approaches, the PMM project has improved the capacity of providers, central level supervisors, and regional and district management teams to conduct data quality assessments and analysis through the implementation of dashboard data desk review and facility-level data quality assessment to enable health managers and providers to develop action plans for solutions to data quality and health information access issues. This brief shares more on this work in Côte d'Ivoire.fs-23-621 PMM
Amélioration de la qualité et de l’utilisation des données sur le paludisme en Côte d’Ivoire pour la prise de décisionPMI Measure Malaria2023French, , , , projet Measure Malaria (PMM) est financé par le programme President’s Malaria Initiative (PMI) de l’Agence des États Unis pour le développement international (USAID). Son objectif principal est de soutenir le renforcement du système d’information sanitaire de routine (SISR) et de la surveillance, du suivi et de l’évaluation du paludisme (SSE) dans les 20 districts sanitaires de la Côte d’Ivoire soutenus par l’USAID. S’appuyant sur les leçons apprises et les réussites du projet MEASURE Evaluation de l’USAID dans la mise à l’échelle des modèles et des approches d’information sanitaire basées sur internet, le projet PMI Measure Malaria cherche à améliorer l’accès aux informations sanitaires de qualité en renforçant l’utilisation des informations sur le paludisme et d’autres informations sanitaires contenues dans le DHIS2 afin de permettre aux gestionnaires des services de santé, prestataires de soins et partenaires techniques et financiers de prendre des décisions fondées sur des données probantes.fs-23-619-FR PMM
Improving Malaria Data Quality and Use in Côte d’Ivoire for Decision MakingPMI Measure Malaria2023English, , , , , PMI Measure Malaria (PMM) is funded through the United States Agency for International Development (USAID) and the U.S. President’s Malaria Initiative (PMI). Its main objective is to support the strengthening of the Routine Health Information System (RHIS) and malaria surveillance, monitoring and evaluation (SME) in 20 USAID-supported health districts in Côte d'Ivoire. Building on the lessons learned and successes of USAID's MEASURE Evaluation project in scaling up web-based health information models and approaches, the PMM project seeks to improve access to quality health information by strengthening the use of malaria and other health information contained in the District Health Information Software, version 2 (DHIS2) to enable health service managers, healthcare providers, and technical and financial partners to make evidence-based decisions. This briefs shares more on this work in Côte d'Ivoire.fs-23-619-EN PMM
Use of Malaria Mobile Dashboard and Scorecard Applications at Health Facilities to Improve Malaria Prevention, Service Delivery, and Commodity Management in Côte d’Ivoire and MadagascarPMI Measure Malaria2023English, , , , , , , The U.S. President’s Malaria Initiative (PMI) Measure Malaria (PMM) project is funded by the United States Agency for International Development (USAID). Its main objective is to support strengthening of the routine health information system and malaria surveillance, monitoring, and evaluation in the 20 USAID-supported districts in Côte d’Ivoire and 12 USAID-supported regions in Madagascar. Building on the lessons learned and successes of USAID’s MEASURE Evaluation project in scaling up web-based health information models and approaches, the PMM project seeks to support the improvement of malaria service delivery and commodity management by developing, implementing, and promoting the use of the innovative malaria mobile dashboard and scorecard applications to increase real-time data access at the health facility level and empower health providers to make evidence-based decisions. This brief shares more on the work.fs-23-627e
Improving the Quality of Health Program Data in MadagascarPMI Measure Malaria2023English, , , The PMI Measure Malaria (PMM) project is funded by the U.S. Agency for International Development’s (USAID) President’s Malaria Initiative (PMI). Its main objective is to support the strengthening of the routine health information system (RHIS) and malaria surveillance, monitoring, and evaluation (SME) in the 12 USAID-supported regions of Madagascar. Building on the lessons learned and successes of USAID's MEASURE Evaluation project in scaling up web-based health information models and approaches, the PMM project seeks to improve access to health information by strengthening the use of District Health Information Software, version 2 (DHIS2) through the integration of hospital, community, and private sector data, and the implementation of mobile and web-based dashboard and scorecard applications (apps) to enable health managers and service providers to make evidence-based decisions. This brief shares more on this work in Madagascar.fs-23-627d
Strengthening Governance of the Health Information System in MadagascarPMI Measure Malaria2023English, , , The PMI Measure Malaria (PMM) project is funded by the U.S. Agency for International Development’s (USAID) President’s Malaria Initiative (PMI). Its main objective is to support the strengthening of the routine health information systems (RHIS) and malaria surveillance, monitoring and evaluation (SME) in the 12 USAID-supported regions of Madagascar. Building on the lessons learned and successes of USAID's MEASURE Evaluation project in scaling up web-based health information models and approaches, the PMM project seeks to strengthen the implementation of standards, the national strategic health information system management plan for access to health information at all levels of the health pyramid by strengthening the use of District Health Information Software, version 2 (DHIS2), and implementing innovative mobile dashboard and dashboard applications (apps) to enable health workers to access health information at all levels. This brief shares more on this work in Madagascar.fs-23-627c PMM
Increasing Access to Comprehensive Health Information with the Integration of Private Sector Data in the DHIS2 National Health Information SystemPMI Measure Malaria2023English, , , , The PMI Measure Malaria (PMM) project is funded by the U.S. Agency for International Development’s (USAID) President’s Malaria Initiative (PMI). Its main objective is to support the strengthening of the routine health information system (RHIS) and malaria surveillance, monitoring and evaluation (SME) in the 12 USAID-supported regions of Madagascar. Since 2021, the Ministry of Public Health (MSANP), conscious of the contributions of the private health sector in the provision of services, developed strategies for the integration of its data in the national health information system (NHIS) which runs on the District Health Information Software, version 2 (DHIS2) platform. Building on the lessons learned from and successes of USAID’s MEASURE Evaluation project in scaling up web-based models and approaches to health information, PMM improves access to comprehensive health information through the integration of hospital, community, and private health data. The project’s aim is to ensure that health service managers and healthcare providers can make appropriate decisions according to the health situation in the country. This brief shares more on this work in Madagascar.fs-23-627b PMM
Increased Access and Use of Malaria and Other Health Program Data in Madagascar Has Improved Decision MakingPMI Measure Malaria2023English, , , , , The PMI Measure Malaria (PMM) project is funded by the U.S. Agency for International Development’s (USAID) President’s Malaria Initiative (PMI). Its main objective is to support the strengthening of the routine health information system (RHIS) and malaria surveillance, monitoring, and evaluation (SME) in the 12 USAID-supported regions of Madagascar. Building on the lessons learned from and successes of USAID's MEASURE Evaluation project in scaling up web-based health information models and approaches, the PMM project seeks to improve access to health information by strengthening the use of District Health Information Software, version 2 (DHIS2) through the integration of hospital, community, and private sector data, as well as the implementation of mobile and web-based scorecard and dashboard applications (apps) to enable health service managers and providers to access health information and make evidence-based decisions. This brief shares more on this work, including the development of mobile apps with malaria dashboards and scorecards linked to DHIS2.fs-23-627a PMM
Évaluation du système de surveillance du paludisme en République démocratique du Congo : Rapport finalPMI Measure Malaria2023French, , , , L’un des principaux piliers de la stratégie mondiale de lutte contre le paludisme, adoptée par la République démocratique du Congo (RDC), est de « transformer la surveillance du paludisme en une intervention centrale ». Bien que la surveillance soit un élément clé de la lutte contre le paludisme en RDC, la qualité, la précision et l’utilisation des données sur le paludisme ne sont pas bien évaluées. Les résultats de cette évaluation nous permettront d’avoir une compréhension claire des principales forces et faiblesses du système de surveillance actuel dans le pays, en classant les lacunes les plus critiques par ordre de priorité pour l’action à court terme. Ils permettront au Programme national de lutte contre le paludisme (PNLP) de suivre plus facilement les progrès de la lutte antipaludique et de prendre des décisions basées sur des données pour hiérarchiser les interventions et allouer les ressources plus efficacement. TR-23-509 PMM FR
Évaluation du système de surveillance du paludisme au Cameroun : Rapport finalPMI Measure Malaria2022French, , , , , Avec le soutien de partenaires, dont l’USAID/PMI, le PNLP mène des actions conformément à ce plan stratégique national, pour renforcer la surveillance du paludisme. Pour apprécier les capacités de ce système de surveillance à répondre efficacement aux besoins en données et en informations sur le paludisme, le projet PMI Measure Malaria (PMM) a réalisé une évaluation de base du système de surveillance du paludisme au Cameroun, dont les résultats vont permettre de mieux orienter les actions du PLNP et aider à mesurer l’amélioration future du système de surveillance du paludisme au Cameroun. Évaluation du système de surveillance du paludisme au Cameroun : Résumé techniqueTR-22-500 PMI
Évaluation du système de surveillance du paludisme au Cameroun : Résumé techniquePMI Measure Malaria2022French, , , , , , Pour apprécier les capacités de ce système de surveillance à répondre efficacement aux besoins en données et en informations sur le paludisme, le projet PMI Measure Malaria (PMM) a commandé une évaluation du système de surveillance du paludisme au Cameroun, dont les résultats vont permettre de mieux orienter les actions du Programme national de lutte contre le paludisme (PLNP) et de mesurer l’amélioration future du système de surveillance du paludisme au Cameroun. Évaluation du système de surveillance du paludisme au Cameroun : Rapport final
Use of Malaria Mobile Dashboards and Scorecard Applications to Access Data at Health Facilities Has Improved Service Delivery and Commodity Management in Cote D’Ivoire and MadagascarPMI Measure Malaria2022English, , , , , , , The U.S. President’s Malaria Initiative (PMI) Measure Malaria (PMM) project is funded by the United States Agency for International Development (USAID). Its main objective is to support strengthening of the routine health information system (RHIS) and malaria surveillance, monitoring, and evaluation (SME) in the 20 USAID-supported districts in Cote d’Ivoire and 12 USAID-supported regions in Madagascar. Building on the lessons learned and successes of USAID’s MEASURE Evaluation project in scaling up web-based health information models and approaches, the PMI Measure Malaria project seeks to address health facility access to health information by developing and implementing innovative malaria mobile dashboard and scorecard applications (apps) to empower health providers to make decisions based on evidence. This brief shares more.fs-22-574-pmi
Innovative Mobile Apps for Malaria Information Access and Use at Health Facilities to Monitor Service Delivery and Commodity Management Performance in PMI Measure Malaria Supported Districts in Cote d’IvoirePMI Measure Malaria2022English, , , , , Despite country stakeholder support to the Cote d’Ivoire Ministry of Health for strengthening health information, the conditions that prevent access to malaria and other health program data at the health facility level remain a challenge—partly because those who collect data do not always have access to the appropriate technology and communicative tools to use it. Health facilities often report their data to districts and do not have the capacity nor mechanisms to review and use their own data for decision making. This lack of access can be explained by: • Limited computers and tablets to store and manage data • Lack of access to landline internet • Lack of digital data applications (apps) Expanding access to key malaria indicators at the health facility level in Cote d’Ivoire will advance the use of information to better understand how services and commodities are delivered and managed and to develop improvement and strengthening plans. The availability of mobile internet networks, electricity, and smartphones provide the project an opportunity to use the District Health Information Software, version 2 (DHIS2) malaria module to select key indicators of surveillance and service delivery at the health facility level to design malaria mobile-friendly dashboard and scorecard apps. The dashboard displays trends of the selected indicators while the scorecard helps monitor health facility performance. The DHIS2-based mobile apps are supported on Android devices and data are accessible both online and offline.fs-22-570-pmm
Increasing Health Facilities’ Access to Health Information for Decision Making and Operational Plan Development in PMI Measure Malaria Supported Districts in MadagascarPMI Measure Malaria2022English, , , , , Health facilities' access to malaria information is essential for the progress and sustainability of the quality of the services and data in Madagascar. Despite country support for strengthening health information, access to data remains a challenge—partly because those who collect data do not always have access to the appropriate tools to use it. Health facilities often report their data to districts and do not have the capacity nor mechanisms to review and use their own data for decision making. This lack of access can be explained by: - Limited computers to store and manage data - Insufficient electricity - Insufficient skilled personnel to use computer software - Lack of access to land line internet Enabling access to and visualization of key malaria indicators at the health facility level will allow health providers to improve the quality of servicedelivery. The project used the District Health Information Software, version 2 (DHIS2) malaria module and the existence of mobile internet networks to select key indicators of surveillance and service delivery at the health facility level to design malaria mobile-friendly dashboard and scorecard apps. The dashboard displays trends of the selected indicators while the scorecard helps monitor health facility performance. The DHIS2-based mobile apps are supported on Android devices and data are accessible both online and offline.fs-22-569-pmi
End Malaria Faster: U.S. President’s Malaria Initiative 2021 – 2026 StrategyPMI2021English, , , , , , , , The U.S. President’s Malaria Initiative (PMI) strategy for 2021 – 2026 aims to greatly reduce malaria deaths and cases in countries that account for 80 percent of the world’s malaria burden — contributing to the global goals of saving more than 4 million lives and averting over 1 billion cases by 2025. Over the next five years, PMI aims to save lives, reduce health inequities, and improve disease surveillance and global health security. With partners, PMI will maximize program efficiency by addressing five focus areas; reach the unreached, strengthen community health systems, keep malaria services resilient, invest locally, and innovate and lead. As a leader in the fight against malaria, PMI has contributed towards making significant progress in its 27 partner counties; 1.5 billion malaria infections have been prevented and 7.6 million lives saved. Although strides have been made, COVID-19, climate change, and conflict threaten gains. These disruptions have been evident in the COVID-19 pandemic as malaria testing rates dropped by 30 percent, leaving cases undetected and untreated. Threats against past and future successes exist, but the world is at a turning point in the fight against malaria. Innovations to combat resistance, improvements in data and supply systems mean that optimal interventions can be deployed where they are needed most. Strong global partnerships can ensure a healthy, resilient market for lifesaving prevention and treatment products. New weapons against malaria are becoming available including vaccines, new types of mosquito nets and public health insecticides and medicines to fight resistance, and new rapid tests to catch infections that have evaded current diagnostic tools. This momentum and strategic application of malaria interventions will end malaria faster.
Associating the scale-up of insecticide-treated nets and use with the decline in all-cause child mortality in the Democratic Republic of Congo from 2005 to 2014Johanna Karemere, Ismael G. Nana, Andrew Andrada, Olivier Kakesa, Eric Mukomena Sompwe, Joris Likwela Losimba, Jacques Emina, Aboubacar Sadou, Michael Humes & Yazoumé Yé 2021English, , , , , , ,

Background To reduce the malaria burden and improve the socioeconomic status of its citizens, the Democratic Republic of Congo scaled up key malaria control interventions, especially insecticide-treated nets (ITNs), between 2005 and 2014. Since then, the effects of these interventions on malaria mortality and morbidity have not been assessed. This study aimed to measure the impact of the National Malaria Control Programme’s efforts and to inform future control strategies.

Methods The authors used data from the Demographic and Health Surveys 2007 and 2013–2014 to assess trends in all-cause childhood mortality (ACCM) against trends in coverage of malaria interventions at national and subnational levels. The authors used the plausibility argument to assess the impact of the malaria control interventions and used Kaplan–Meier survival probability and Cox proportional hazard models to examine the effect of ITN ownership on child survival. Contextual factor trends affecting child survival were also considered.

Results Countrywide, household ownership of at least one ITN increased, from 9% in 2007 to 70% in 2013–2014. All provinces experienced similar increases, with some greater than the national level. ITN use increased between 2007 and 2013–2014 among children under five (6% to 55%). Severe anaemia (haemoglobin concentration < 8 g/dl) prevalence among children aged 6–59 months significantly decreased, from 11% (95% confidence interval [CI] 9–13%) in 2007 to 6% (95% CI 5–7%) in 2013–2014. During the same period, ACCM declined, from 148 (95% CI 132–163) to 104 (95% CI 97–112) deaths per 1000 live births. The decline in ACCM was greater among children aged 6–23 months (relative reduction of 36%), compared to children aged 24–59 months (relative reduction of 12%). Cox regression indicated that household ownership of at least one ITN reduced the risk of mortality by 24% among children under five (risk ratio = 0.76, 95% CI 0.64–0.90). Contextual factor analysis revealed marginal improvements in socioeconomic indicators and other health interventions.

Conclusions Given the patterns of the coverage of malaria control interventions, patterns in ACCM by province, and marginal improvements in contextual factors, the authors conclude that the malaria control interventions have plausibly contributed to the decrease in ACCM in the Democratic Republic of Congo from 2005 to 2014.

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Estimating the Fraction of Severe Malaria among Malaria-Positive Children: Analysis of Household Surveys in 19 Malaria-Endemic Countries in Africa2020English, , , , To date, the only robust estimates of severe malaria cases include children who present to the formal healthcare system. It is a challenge to use these data because of varying age ranges of reporting, different diagnosis techniques, surveillance methods, and healthcare utilization. This analysis examined data from 37 Demographic and Health Surveys and Malaria Indicator Surveys across 19 countries in sub-Saharan Africa collected between 2011 and 2018. The outcome of interest is a proxy indicator for severe malaria, defined as a proportion of children aged 6–59 months with at least one self-reported symptom of severe illness including loss of consciousness, rapid breathing, seizures, or severe anemia (hemoglobin < 5 g/dL) among those who were positive for malaria. The study includes a weighted descriptive, country-level analysis and a multilevel mixed-effects logistic regression model to assess the determinants of severe malaria. Among children positive for malaria across all surveys, 4.5% (95% CI: 4.1–4.8) had at least one sign or symptom of severe malaria, which was significantly associated with age, residence, wealth, and year of survey fieldwork at a P-value less than 0.05. This analysis presents a novel and an alternative approach of estimating the fraction of severe malaria cases among malaria-positive children younger than 5 years in malaria-endemic countries. Estimating severe malaria cases through population-based surveys allows countries to estimate severe malaria across time and to compare with other countries. Having a population-level estimate of severe malaria cases helps further our understanding of the burden and epidemiology of severe malaria.
Management of uncomplicated malaria among children under five years at public and private sector facilities in MaliSeydou Fomba, Diakalia Koné, Bakary Doumbia, Diadier Diallo, Thomas Druetz, Lia Florey, Thomas P. Eisele, Erin Eckert, Jules Mihigo & Ruth A. Ashton2020English, , , ,   Background: Prompt and effective malaria diagnosis and treatment is a cornerstone of malaria control. Case management guidelines recommend confirmatory testing of suspected malaria cases, then prescription of specific drugs for uncomplicated malaria and for severe malaria. This study aims to describe case management practices for children aged 1–59 months seeking treatment with current or recent fever from public and private, rural and urban health providers in Mali. Methods: Data were collected at sites in Sikasso Region and Bamako. Health workers recorded key information from the consultation including malaria diagnostic testing and result, their final diagnosis, and all drugs prescribed. Children with signs of severe diseases were ineligible. Consultations were not independently observed. Appropriate case management was defined as both 1) tested for malaria using rapid diagnostic test or microscopy, and 2) receiving artemisinin combination therapy (ACT) and no other antimalarials if test-positive, or receiving no antimalarials if test-negative. Results: Of 1602 participating children, 23.7% were appropriately managed, ranging from 5.3% at public rural facilities to 48.4% at community health worker sites. The most common reason for ‘inappropriate’ management was lack of malaria diagnostic testing (50.4% of children). Among children with confirmed malaria, 50.8% received a non-ACT antimalarial (commonly artesunate injection or artemether), either alone or in combination with ACT. Of 215 test-negative children, 44.2% received an antimalarial drug, most commonly ACT. Prescription of multiple drugs was common: 21.7% of all children received more than one type of antimalarial, while 51.9% received an antibiotic and antimalarial. Inappropriate case management increased in children with increasing axillary temperatures and those seeking care over weekends. Conclusions: Multiple limitations in management of febrile children under five were identified, including inconsistent use of confirmatory testing and apparent use of severe malaria drugs for uncomplicated malaria. While we cannot confirm the reasons for these shortcomings, there is a need to address the high use of non-ACT antimalarials in this context; to minimize potential for drug resistance, reduce unnecessary expense, and preserve life-saving treatment for severe malaria cases. These findings highlight the challenge of managing febrile illness in young children in a high transmission setting.  ja-20-287-pmm
Estimating malaria chemoprevention and vector control coverage using program and campaign data: A scoping review of current practices and opportunitiesJohanna Nice, Honelgn Nahusenay, Erin Eckert, Thomas P Eisele, and Ruth A Ashton2020English, , , , , , Background: Accurate estimation of intervention coverage is a vital component of malaria program monitoring and evaluation, both for process evaluation (how well program targets are achieved), and impact evaluation (whether intervention coverage had an impact on malaria burden). There is growing interest in maximizing the utility of program data to generate interim estimates of intervention coverage in the periods between large-scale cross-sectional surveys (the gold standard). As such, this study aimed to identify relevant concepts and themes that may guide future optimization of intervention coverage estimation using routinely collected data, or data collected during and following intervention campaigns, with a particular focus on strategies to define the denominator.

Methods: We conducted a scoping review of current practices to estimate malaria intervention coverage for insecticide-treated nets (ITNs); indoor residual spray (IRS); intermittent preventive treatment in pregnancy (IPTp); mass drug administration (MDA); and seasonal malaria chemoprevention (SMC) interventions; case management was excluded. Multiple databases were searched for relevant articles published from January 1, 2015 to June 1, 2018. Additionally, we identified and included other guidance relevant to estimating population denominators, with a focus on innovative techniques.

Results: While program data have the potential to provide intervention coverage data, there are still substantial challenges in selecting appropriate denominators. The review identified a lack of consistency in how coverage was defined and reported for each intervention type, with denominator estimation methods not clearly or consistently reported, and denominator estimates rarely triangulated with other data sources to present the feasible range of denominator values and consequently the range of likely coverage estimates.

Conclusions: Though household survey-based estimates of intervention coverage remain the gold standard, efforts should be made to further standardize practices for generating interim measurements of intervention coverage from program data, and for estimating and reporting population denominators. This includes fully describing any projections or adjustments made to existing census or population data, exploring opportunities to validate available data by comparing with other sources, and explaining how the denominator has been restricted (or not) to reflect exclusion criteria.
Standard Operating Procedures for the Health Facility Registers and Summary Forms: Data Management Procedures Manual IIMEASURE Evaluation2020English, , , , , , The purpose of these standard operating procedures (SOPs) is to provide guidance in filling health facility registers and summary forms at the health facility level. These SOPs are an additional document to the Standard Operating Procedures for the Health Management Information System: Data Management Procedures Manual I. ms-20-193
Standard Operating Procedures for the Health Management Information System: Data Management Procedures Manual IMEASURE Evaluation2020English, , , , , , , A health management information system (HMIS) is a routine, integrated system for the collection, collation, analysis, presentation, dissemination, and use of relevant health‐related information. It covers other health information system (HIS) sub‐systems, such as the human resources information system, administrative records, integrated disease surveillance and response, the logistics management information system, registration of births and deaths, population‐based information systems, and research‑generated health information. It is designed for use at the community and health facility levels, and by district health management teams, local councils, civil society organizations, partners, and the Ministry of Health and Sanitation (MOHS) for planning, allocating resources, and managing and evaluating the healthcare delivery system.

The Data Management Procedures Manual, within the context of the HIS, is a written description of the management practices required for effective coordination, monitoring, and supervision of the HIS, as well as the procedures required to address issues relating to data collection, quality, and accessibility. The Data Management Procedures Manual should therefore accurately reflect good information management practices, be sufficiently practical, and be usable in the HIS sub‐system. Good HIS management practices relate to general aspects of HIS management functions, including the following: data collection, compilation, analysis, storage, and processing; records storage; handling of urgent data requests and needs; and management of the devices, tools, and appliances used to manage the data.

The goal of the Standard Operating Procedures for HMIS: Data Management Procedures Manual is to provide a standardized system of data management practices for the MOHS and its partners, with the view of reaching maximum data accuracy, correctness, completeness, integrity, and reproducibility in the HMIS in Sierra Leone. The application of the Data Management Procedures Manual requires effective coordination and oversight at all levels.

Access the related Standard Operating Procedures for the Health Facility Registers and Summary Forms: Data Management Procedures Manual II.
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Report on the Review of Sierra Leone’s National Malaria Monitoring and Evaluation Plan 2016–2020: Addendum to the Malaria Programme ReviewMEASURE Evaluation2020EnglishThe Sierra Leone Ministry of Health and Sanitation’s National Malaria Control Programme (NMCP) developed and launched the Sierra Leone Malaria Strategic Plan (SLMSP) 2016–2020, which was based on recommendations from the malaria program review (MPR) 2013, the recognition of the impact of malaria interventions, and the Sierra Leone Health Sector Recovery Plan 2015–2020. The SLMSP has guided the implementation of key malaria interventions as Sierra Leone continues to strengthen the country’s effort in the fight against malaria.

The SLMSP follows the guiding principles of the broader National Health Sector Strategic Plan 2010–2015, the Sierra Leone Health Recovery Plan 2015–2020, the National Ebola Strategy for Sierra Leone 2015–2017, and the Basic Package of Essential Health Services 2010 (revised 2015). Among these principles are universal coverage with proven malaria interventions; equity, equality, and nondiscrimination; participation and accountability; and the right to the health elements of availability, accessibility, acceptability, adequacy, quality, and contiguous expansion of interventions.

The national malaria monitoring and evaluation (M&E) plan 2016–2020 was developed alongside the SLMSP. The malaria M&E plan 2016–2020 is aligned to the SLMSP 2016–2020 and contains priority indicators that the NMCP uses to monitor and evaluate the implementation of the intervention strategies and track the performance of the malaria program.

The objectives of the M&E plan review were as follows:
  • To review the existing malaria M&E plan 2016–2020
  • To provide recommendations for developing a well-aligned comprehensive national M&E plan in preparation for the national malaria strategy 2021–2025
  • To build consensus on the understanding of a specific, measurable, relevant, attainable, and time-based (“SMART”) and actionable malaria M&E plan
  • To contribute to the MPR
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    Cadre d’évaluation des programmes nationaux de lutte contre le paludisme dans les zones de transmission modérée et faibleGroupe de travail sur l’évaluation du Groupe de référence pour le suivi et l’évaluation de Roll Back Malaria2020French, , , Le cadre d'évaluation présenté dans ce document a l'intention de s'appuyer sur les travaux existants du Groupe de référence pour le suivi et l'évaluation de la gestion axée sur les résultats, en l'étendant pour aborder les paramètres le long du continuum de la transmission du paludisme, en mettant l'accent sur les paramètres de transmission modérée et faible. Ce cadre souligne également l'importance de l'évaluation des processus pour l'évaluation de l'impact, en reliant les processus de mise en œuvre à la force de la mise en œuvre pour ensuite démontrer l'impact du programme sur la transmission, la morbidité ou la mortalité du paludisme.

    Accédez au Framework for Evaluating National Malaria Programs in Moderate and Low Transmission Settings: Aide Memoire.
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    A Compendium of the Kenya Malaria Programme Review 2018Kenya Ministry of Health2020English, , , , Kenya conducted a malaria programme review (MPR) at the end of the Kenya Malaria Strategy (KMS) 2009–2018 (revised 2014). The MPR was conducted to assess the progress made during the implementation of the KMS 2009–2018. Recommendations and findings of the MPR informed the development of the KMS 2019–2023. The MPR consisted of nine thematic area reviews formed along the key strategic and intervention areas of the KMS 2009–2018. The thematic area reviews were evidence-based assessments of progress made against the KMS objectives and strategies. This compendium contains 10 separate reports developed as part of the MPR. Chapter 1 contains the report detailing the process for conducting the MPR and the nine thematic reviews. Chapters 2–10 provide the nine thematic reports, covering these areas: programme management; finance; procurement and supply management (PSM); vector control; malaria in pregnancy; case management; advocacy, communication, and social mobilisation (ACMS); epidemic preparedness and response (EPR); and surveillance, monitoring, evaluation, and operational research (SMEOR). These thematic reviews provided the information used to develop the main findings and recommendations of the MPR.
    Regional Dissemination Workshops for the Kenya Malaria Strategy (2019-2023)Kenya Ministry of Health2020English, , , , , Malaria remains a public health and socioeconomic problem in Kenya, with about three-quarters of the population estimated to be at risk of the disease. Moreover, the burden of the disease varies across the 47 counties in the country. The National Malaria Policy, the Kenya Malaria Strategy (KMS), and the Monitoring and Evaluation Plan provide a framework for guiding the response to the malaria burden in Kenya. The Kenya Malaria Strategy 2019–2023 was launched on 25 April 2019 during World Malaria Day. The strategy was developed based on recommendations from the end-term review of the KMS 2009– 2018, through the 2018 Malaria Programme Review process. The goal of KMS 2019–2023 is to reduce malaria incidence and deaths by at least 75% of 2016 levels by 2023. This ambitious goal is set to be achieved through implementation of six strategic objectives. The six objectives focus on interventions ranging from continued scaling-up of preventive measures to attain universal coverage, prompt diagnosis and effective treatment in all sectors, strengthened performance monitoring, and establishment of systems for malaria elimination in selected counties. Achievement of the KMS goal and objectives is pegged on enhanced coordination and collaboration with all malaria stakeholders in the country, and especially with the counties and the community health strategy. It is against this backdrop that the Division of National Malaria Programme (DNMP) organised five regional workshops for the dissemination of KMS 2019–2023 alongside other supporting policy documents to all the 47 counties in the country. The specific objectives of the workshops were to: Disseminate the Kenya malaria strategy and monitoring and evaluation (M&E) plan (2019–2023); obtain feedback and inputs from the counties on implementation of the strategy; provide highlights on current policy and guidance documents; share latest updates and information from DNMP, counties, and partners; assess the status of key malaria indicators; and define the next steps in implementing the strategy and tracking performance. The workshops deliberated and agreed on innovative ways for the county teams to further cascade dissemination of the strategy to the sub-counties and health facilities. Following the successful regional dissemination workshops, counties are now able to align malaria control activities to their county integrated development plans and annual work plans to the KMS 2019–2023. Counties can also use KMS to lobby for increased funding for malaria interventions in their counties, and to guide linkages with community health strategy. This report is a synthesised analysis of the proceedings in the five regional dissemination workshops, with special emphasis on issues cutting across all the counties. Implementation of the recommendations from the workshops will go a long way in supporting achievement of the KMS 2019–2013 goals and objectives.
    Guidelines for Malaria Epidemic Preparedness and Response in Kenya: 2nd EditionKenya Ministry of Health2020English, , , , Malaria epidemics re-emerged in Kenya in the 1990s. The epidemics are usually characterized by high morbidity and mortality within a considerably short period of time. Malaria epidemics usually disrupt health services and negatively affect socio-economic growth. In Kenya, malaria epidemics occur in two epidemiological zones—the western highlands and the arid and semi-arid lowlands of northern Kenya and south-eastern parts of the country. The epidemics are associated with unusual climatic conditions, mainly high rainfall and sustained minimum temperatures around 18°C, which sustain vector breeding and longer survival of the malaria vectors. Malaria epidemics usually occur among non-immune or semi-immune populations. The main objective of malaria epidemic preparedness and response is to reduce morbidity and mortality associated with malaria epidemics among the affected populations. This is achieved through early detection of epidemics and immediate implementation of control and preventive measures. These guidelines provide information designed to facilitate effective management of malaria epidemics in all epidemic-prone areas of the country. The guidelines are adaptable for use at all levels of care and provide mechanisms and approaches to contain malaria epidemics in all settings, including in complex emergencies. The guidelines are a reference document to guide the planning and implementation of malaria control interventions in epidemic situations. The guidelines will be used by planners and policy makers at the national level, health managers at the county and sub-county levels, healthcare workers at the service delivery level, and partners. This document will also be useful to all partners and stakeholders involved in malaria control, including civil society organizations and donors.
    Malaria Epidemic Preparedness and Response Rapid Assessment ReportKenya Ministry of Health2020English, , , , Malaria epidemics usually occur in the western highlands and the arid and semi-arid regions of Kenya. These epidemics are characterised by high morbidity and mortality. Malaria epidemic preparedness and response (EPR) is geared towards the reduction of morbidity and mortality during epidemics through timely detection and response. A malaria programme review conducted in 2018 revealed suboptimal performance on EPR indicators and activities. Thus, the Division of National Malaria Programme (DNMP)—with support from the United States Agency for International Development (USAID)- and the U.S. President’s Malaria Initiative (PMI)-funded MEASURE Evaluation project—conducted malaria EPR planning and review workshops for 127 sub-counties in 26 epidemic-prone counties in Kenya. The workshops were conducted between January and March 2019 to build the capacity of health managers to set thresholds to monitor and detect epidemics early and initiate appropriate responses. Rapid assessment visits were conducted in November 2019 to assess the level of preparedness and response to malaria epidemics in the counties and sub-counties trained. Ten of the counties trained were randomly selected for the rapid assessment.

    A rapid assessment tool was developed through a consultative process involving the DNMP, the Division of Disease Surveillance and Response (DDSR), and MEASURE Evaluation. The tool assessed the level of preparedness and response to malaria epidemics in the counties and subcounties selected. The objectives of the rapid assessment were to assess vulnerability to malaria epidemics in the selected counties and establish the level of preparedness and readiness of counties and sub-counties to respond to detected outbreaks and their resource needs to respond to potential epidemics.

    This report details the assessment and results.
    Malaria Epidemic Preparedness and Response in Kenya: Trainers GuideKenya Ministry of Health2020English, , , , Malaria epidemic preparedness and response (EPR) is an important strategy for malaria control, involving early detection and early deployment of response interventions to contain the epidemics. Malaria epidemics usually occur among nonimmune or semi-immune populations because of their infrequent exposure to malaria infection. Therefore, malaria epidemics tend to create an emergency that requires urgent attention to prevent high morbidity and the potential for high mortality among affected vulnerable populations. To address malaria epidemics effectively, the health systems should be able to predict and detect the evolution of malaria epidemics and have the flexibility to respond rapidly to contain detected epidemics. The Ministry of Health, through the Division of the National Malaria Programme and its partners, has been supporting targeted counties and sub-counties to develop capacity for malaria EPR. This approach ensures that the health management teams in the targeted counties have developed EPR plans that include resources to prepare the health workforce to respond in the event of epidemics. Since the change of governance to the devolved system in 2012, a lot of changes in the delivery of health services and, by extension, malaria control, have occurred. Consequently, previously built capacity for malaria EPR has eroded over time owing to high health worker turnover both at the management and operational levels. In view of these changes, the Division of the National Malaria Programme recognised the need to devise a mechanism for continuous capacity development for malaria EPR in all 26 counties (127 sub-counties) prone to malaria epidemics. This training guide has been developed to facilitate continuous capacity development for malaria EPR at subnational levels. This capacity comprises training, planning for, and implementation of EPR activities that include prediction, detection, and effective responses to contain malaria epidemics. This first edition of the malaria EPR training guide comprises PowerPoint slides and an implementation guide outlining the objectives and guide content, The implementation guide can be scoped and adapted to address the knowledge and skill needs of every level of healthcare in Kenya. The guide will be useful to all stakeholders involved in malaria control: health managers, trainers, and service providers across all levels of the healthcare system.
    Malaria Epidemic Preparedness and Response in Kenya: Implementation GuideKenya Ministry of Health2020English, , , , Malaria epidemic preparedness and response (EPR) is an important strategy for malaria control, involving early detection and early deployment of response interventions to contain the epidemics. Malaria epidemics usually occur among nonimmune or semi-immune populations because of their infrequent exposure to malaria infection. Therefore, malaria epidemics tend to create an emergency that requires urgent attention to prevent high morbidity and the potential for high mortality among affected vulnerable populations. To address malaria epidemics effectively, the health systems should be able to predict and detect the evolution of malaria epidemics and have the flexibility to respond rapidly to contain detected epidemics. The Ministry of Health, through the Division of the National Malaria Programme and its partners, has been supporting targeted counties and sub-counties to develop capacity for malaria EPR. This approach ensures that the health management teams in the targeted counties have developed EPR plans that include resources to prepare the health workforce to respond in the event of epidemics. Since the change of governance to the devolved system in 2012, a lot of changes in the delivery of health services and, by extension, malaria control, have occurred. Consequently, previously built capacity for malaria EPR has eroded over time owing to high health worker turnover both at the management and operational levels. In view of these changes, the Division of the National Malaria Programme recognised the need to devise a mechanism for continuous capacity development for malaria EPR in all 26 counties (127 sub-counties) prone to malaria epidemics. This implementation guide has been developed to facilitate continuous capacity development for malaria EPR at subnational levels. This capacity comprises training, planning for, and implementation of EPR activities that include prediction, detection, and effective responses to contain malaria epidemics. The implementation guide can be scoped and adapted to address the knowledge and skill needs of every level of healthcare in Kenya. The guide will be useful to all stakeholders involved in malaria control: health managers, trainers, and service providers across all levels of the healthcare system.
    Malaria Epidemic Preparedness and Response in Kenya: Participants GuideKenya Ministry of Health2020English, , , , Malaria epidemic preparedness and response (EPR) is an important strategy for malaria control, involving early detection and early deployment of response interventions to contain the epidemics. Malaria epidemics usually occur among nonimmune or semi-immune populations because of their infrequent exposure to malaria infection. Therefore, malaria epidemics tend to create an emergency that requires urgent attention to prevent high morbidity and the potential for high mortality among affected vulnerable populations. To address malaria epidemics effectively, the health systems should be able to predict and detect the evolution of malaria epidemics and have the flexibility to respond rapidly to contain detected epidemics. The Ministry of Health, through the Division of the National Malaria Programme and its partners, has been supporting targeted counties and sub-counties to develop capacity for malaria EPR. This approach ensures that the health management teams in the targeted counties have developed EPR plans that include resources to prepare the health workforce to respond in the event of epidemics. Since the change of governance to the devolved system in 2012, a lot of changes in the delivery of health services and, by extension, malaria control, have occurred. Consequently, previously built capacity for malaria EPR has eroded over time owing to high health worker turnover both at the management and operational levels. In view of these changes, the Division of the National Malaria Programme recognised the need to devise a mechanism for continuous capacity development for malaria EPR in all 26 counties (127 sub-counties) prone to malaria epidemics. This participants training guide has been developed to facilitate continuous capacity development for malaria EPR at subnational levels. This capacity comprises training, planning for, and implementation of EPR activities that include prediction, detection, and effective responses to contain malaria epidemics. This first edition of the malaria EPR training guide comprises an introductory section outlining the objectives and content of the course and PowerPoint slides. The course will be useful to all stakeholders involved in malaria control: health managers, trainers, and service providers across all levels of the healthcare system.
    Malaria Routine Data Quality Assessment Tool: A Checklist to Assess the Quality of Malaria Program DataMEASURE Evaluation2020English, , , , A comprehensive approach to data quality assurance should include three complementary approaches using standardized methods and tools. These approaches are as follows: - Routine and regular (i.e., monthly) reviews of data quality built into a system of checks of the malaria or other program reporting systems as part of a feedback cycle that identifies errors in near real-time so that they can be corrected as they occur. - An annual independent assessment of a core set of tracer indicators to identify gaps and errors in reporting and the plausibility of trends in health facility data reported during the previous year. - Periodic in-depth program-specific reviews of data quality that focus on a single disease or program area and are timed to meet the planning needs of the specific programs (e.g., before program reviews). This tool aims to standardize and facilitate the routine review of malaria data quality at health facilities, by the district monitoring and evaluation teams that support them via routine supervision to health facilities. While the Malaria Routine Data Quality Assessment (MRDQA) tool provides some details on use of the tool, a User Manual expanded details exists and is meant to accompany this tool.tl-20-85
    Malaria Routine Data Quality Assessment Tool: User ManualMEASURE Evaluation2020English, , , , , In 2020, the United States Agency for International Development- and U.S. President’s Malaria Initiative-funded MEASURE Evaluation project developed the Malaria Routine Data Quality Assessment (MRDQA) Tool: A Checklist to Assess the Quality of Malaria Program Data, for use by malaria programs. The MRDQA tool is a checklist that supports a targeted, rapid data-quality assessment focused on malaria data for use in routine data quality monitoring as part of regular supervision efforts. The tool aims to standardize and facilitate the routine assessment of malaria data quality by a district team during supportive supervision visits at health facilities. The tool can also be used by central and regional staff jointly with district teams to assist in data quality efforts. This manual describes the purpose and structure of the MRDQA tool and offers considerations for personnel and logistics, sampling considerations, details on preparing for fieldwork, and step-by-step instructions for using the tool. The MRDQA tool provides even more detail on use of the tool in the Instructions tab.ms-20-190
    Surveillance, Suivi, et Evaluation des Programmes de Lutte contre le Paludisme : Cours en LigneMEASURE Evaluation2020French, , , , , La surveillance, suivi et'évaluation (SSE) jouent un rôle vital dans tous les programmes de contrôle et de prévention du paludisme. Ce cours en ligne, offert par PMI Measure Malaria, fournit une introduction complète aux SSE des programmes de lutte contre le paludisme. Téléchargez un PDF du cours complet ou téléchargez les modules individuels ci-dessous. Pour accéder au cours en ligne de certification, rendez-vous sur ce site: www.memalaria.org. Englishms-20-184-fr
    Use of Routine Health Information System Data to Evaluate Impact of Malaria Control Interventions in Zanzibar, Tanzania from 2000 to 2015Ashton, R., Bennett, A., Al-Mafazy, A.-W., Abass, A. K., Msellem, M. I., McElroy, P. . . . Bhattarai, A.2019English, , , , , , , ,

    Background

    Impact evaluations allow countries to assess public health gains achieved through malaria investments. This study uses routine health management information system (HMIS) data from Zanzibar to describe changes in confirmed malaria incidence and impact of case management and vector control interventions during 2000–2015.

    Methods

    HMIS data from 129 (82%) public outpatient facilities were analyzed using interrupted time series models to estimate the impact of artemisinin-based combination therapy (ACT), indoor residual spray, and long-lasting insecticidal nets. Evaluation periods were defined as pre-intervention (January 2000 to August 2003), ACT-only (September 2003 to December 2005) and ACT plus vector control (2006–2015).

     

    Findings

    After accounting for climate, seasonality, diagnostic testing rates, and outpatient attendance, average monthly incidence of confirmed malaria showed no trend over the pre-intervention period 2000–2003 (incidence rate ratio (IRR) 0.998, 95% CI 0.995–1.000). During the ACT-only period (2003–2005), the average monthly malaria incidence rate declined compared to the pre-intervention period, showing an overall declining trend during the ACT-only period (IRR 0.984, 95% CI 0.978–0.990). There was no intercept change at the start of the ACT-only period (IRR 1.081, 95% CI 0.968–1.208), but a drop in intercept was identified at the start of the ACT plus vector control period (IRR 0.683, 95% CI 0.597–0.780). During the ACT plus vector control period (2006–2015), the rate of decline in average monthly malaria incidence slowed compared to the ACT-only period, but the incidence rate continued to show an overall slight declining trend during 2006–2015 (IRR 0.993, 95% CI 0.992–0.994).

     

    Interpretation

    This study presents a rigorous approach to the use of HMIS data in evaluating the impact of malaria control interventions. Evidence is presented for a rapid decline in malaria incidence during the period of ACT roll out compared to pre-intervention, with a rapid drop in malaria incidence following introduction of vector control and a slower declining incidence trend thereafter.
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    Facilitating Surveillance, Monitoring, and Evaluation in Malaria-Endemic Countries: A Compendium for National Malaria ProgramsMEASURE Evaluation2019English, , , , , , Concerted efforts in malaria control have led to a significant decrease in the disease burden globally and specifically in sub-Saharan Africa (SSA). Countries there have scaled up proven malaria interventions, such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), diagnostic testing, prompt and effective treatment of malaria cases, and intermittent preventive treatment in pregnancy (IPTp). A strong surveillance, monitoring, and evaluation (SME) system is needed to measure progress and achievement to inform future efforts and investments. This compendium is designed for national malaria program (NMP) personnel, who need to learn SME skills quickly and apply them immediately to their work. It is also intended to be a valuable resource for implementing partners working on malaria projects, students taking an SME course in an MPH program, and scientists interested in malaria SME. Relevant documents and guidance materials are referred to throughout the document. Readers are encouraged either to read through the compendium in its entirety or reference specific chapters, as needed. Chapter 1 introduces the concepts of malaria SME. Chapters 2 and 3 look at the global burden of malaria and global efforts to control malaria. Chapter 4 discusses the role of data for decision making. Chapters 5 through 8 describe the development of an SME plan and a plan’s components: frameworks, indicators, and data sources. Chapter 9 discusses malaria surveillance—a concept particularly important as malaria transmission decreases and NMPs need to track each case closely. Chapter 10 describes key methods used for evaluating NMPs and provides references to key indicators, data sources, and practical examples. Chapter 11 discusses the nuts and bolts of data quality, data management, and data analysis. Chapter 12 focuses on what is needed to present, interpret, and use data correctly. Finally, Chapter 13 presents ethical concerns to think about in malaria SME.ms-19-181
    Surveillance, Monitoring, and Evaluation of Malaria Programs: Online CourseMEASURE Evaluation2020English, , , , , ,

    Surveillance, monitoring, and evaluation (SME) plays a vital role in all malaria control and prevention programs. This course provides a comprehensive introduction to SME of malaria programs.

    Download a PDF of the full course or download the individual modules below. The course is also available in French.

    To access the online course for certification, go to www.memalaria.org.

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    Caregiver exposure to malaria social and behaviour change messages can improve bed net use among children in an endemic country: secondary analysis of the 2015 Nigeria Malaria Indicator SurveyKirsten Zalisk, Samantha Herrera, Uwem Inyang, Audu Bala Mohammed, Perpetua Uhomoibhi, & Yazoum Y2019English, , , ,

    Background: To reduce the malaria burden in Nigeria, the National Malaria Strategic Plan (NMSP) 20142020 calls for the scale-up of prevention and treatment interventions, including social and behaviour change (SBC). SBC interventions can increase awareness and improve the demand for and uptake of malaria interventions. However, there is limited evidence supporting the implementation of SBC interventions to improve key malaria behaviours, such as insecticide-treated bed net (ITN) use, among children in Nigeria.

    Methods: Using data from 2015 Nigeria Malaria Indicator Survey, this study used multiple logistic regression to assess the relationship between caregiver exposure to malaria messages and ITN use among children under fve.

    Results: Caregiver exposure to ITN-related messages was signifcantly associated with ITN use among children under fve (odds ratio [OR]=1.63, p<0.001).

    Conclusions: The results suggest that caregiver exposure to topic-specifc SBC messages improves the use of ITNs among children. Given these results, Nigeria should strive to scale up SBC interventions to help increase ITN use among children in line with the objectives of the NMSP. Further evidence is needed to determine which SBC interventions are the most efective and scalable in Nigeria.

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    A subnational profiling analysis reveals regional differences as the main predictor of ITN ownership and use in NigeriaAndrew Andrada, Samantha Herrera, Uwem Inyang, Audu Bala Mohammed, Perpetua Uhomoibhi, & Yazoum Y2019English, , ,

    Background To reduce the malaria burden in Nigeria, the country is scaling up prevention and treatment interventions, especially household ownership and use of insecticide-treated nets (ITNs). Nevertheless, large gaps remain to achieve the goals of the National Malaria Strategic Plan 20142020 of universal access to ITNs and their increased use. To inform the targeting of intervention strategies and to maximize impact, the authors conducted a sub-national profiling of household ITN ownership and use in the general population to identify key predictors of ITN ownership and use, and the sub-groups that are at higher risk of low ITN coverage and use.

    Methods The authors conducted a secondary analysis of data from the 2015 Nigeria Malaria Indicator Survey. Using the Chi square automatic interaction detector (CHAID) and multiple logistic regression analysis, the authors examined the key predictors of ITN ownership and use in the general population throughout Nigeria.

    Results The CHAID models identified region of the country as the best predictor of household ownership of at least one ITN and its use in the general population, with higher ownership and use observed in the northern regions. The odds of a household owning an ITN were five times greater in the North West region compared with the North Central region (odds ratio [OR]=5.47, 95% confidence interval [CI] 4.466.72, p<0.001). The odds of ITN use were two times greater for those living in the North West region compared with the North Central region (OR=2.04, 95% CI 1.732.41, p<0.001). Other significant predictors were household size, head of household education level, household wealth quintile, and place of residence. The CHAID gain index results identified households in the South West, North Central and South Central regions with low ITN ownership, and the general population in the South South, South East and North Central regions with low ITN use.

    Conclusions This study reveals regional differences in ITN ownership and use in Nigeria. Therefore, the findings from this analysis provide evidence that could inform the NMEP to better target future campaign and routine distribution of ITNs, to achieve universal access and increased use by 2020 in Nigeria.

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    Coverage of Malaria Interventions in Nigeria: Secondary Analysis of Data from National SurveysMEASURE Evaluation2019English, , ,

    Malaria is a major public health burden in Nigeria, posing a risk to the entire population. In 2014, the country reported more than 7.8 million confirmed cases of malaria and more than 6,000 malaria deaths. Malaria accounts for approximately 60 percent of outpatient visits and 30 percent of hospitalizations among children under five. Over the past decade, substantial efforts have been made in malaria control by the government and its partners to expand coverage of insecticide-treated nets, conduct intermittent preventive treatment in pregnancy, and improve and scale up malaria case management.

    To further its efforts to reduce the malaria burden, the National Malaria Elimination Programme (NMEP) and its partners are working to scale up malaria interventions in line with the Nigeria's National Malaria Strategic Plan 20142020.

    To measure progress of malaria control achievements in the past decade in Nigeria and to guide future investments, Nigeria has implemented several population-based surveys, including the Nigeria Malaria Indicator Survey in 2010 and 2015, and the Nigeria Demographic and Health Survey in 2008 and 2013.

    In response to a request from the President's Malaria Initiative (PMI), MEASURE Evaluation, which is funded by the United States Agency for International Development, conducted this research study to provide further evidence to guide both PMIs and NMEPs efforts in malaria program implementation in Nigeria.

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    Framework for Evaluating National Malaria Programs in Moderate- and Low- Transmission SettingsEvaluation Task Force of the RBM Monitoring and Evaluation Reference Group2019English, , ,

    The evaluation framework presented in this document intends to build on existing work by the RBM Monitoring and Evaluation Reference Group, expandingit to address settings along the continuum of malaria transmission, with a specific focus on moderate- and low-transmission settings. This framework also emphasizes the importance of process evaluation to impact evaluation, linking implementation processes to implementation strength to then demonstrate program impact on malaria transmission, morbidity, or mortality.

    Access the related Framework for Evaluating National Malaria Programs in Moderate and Low Transmission Settings: Aide Memoire.

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    MEASURE Evaluations Strategy to Respond to National Malaria Control Program Needs in Surveillance, Monitoring, and Evaluation2019English, , , ,

    The Malaria Technical Area (MTA) of the United States Agency for International Development-funded MEASURE Evaluation projectwith support from the Presidents Malaria Initiative (PMI)has increased its country presence in priority countries to provide direct technical support to national malaria control programs (NMCPs). This support is provided through a MEASURE Evaluation-appointed malaria resident advisor (MRA). MRAs have extensive experience in malaria surveillance, monitoring, and evaluation (SME), and their responsibilities consist of overseeing MEASURE Evaluations in-country work, developing close relationships with the NMCP, and liaising with the MTA headquarters staff. Depending on the scope of the countrys portfolio, additional SME staff may provide support to the MRA and form the rest of the in-country team.

    Each MRA has a tailored set of duties and challenges related to the needs of his or her assigned countrys NMCP. Although each MRA works to achieve the same goal of supporting the NMCP, there is limited direct interaction across countries. To promote the exchange of MRA experiences and lessons learned, MEASURE Evaluation hosted a meeting in October 2017 under the theme, MEASURE Evaluations Malaria Technical Area: Transitioning to effective NMCP leadership in generating and using malaria information. This four-day cross-fertilization meeting brought together MRAs and NMCP staff from the Democratic Republic of the Congo (DRC), Liberia, Madagascar, and Mali to discuss approaches and experiences in providing effective support to NMCPs. The meeting objectives were as follows:

    • Understand MTA in-country activities and how they link with NMCP needs in SME
    • Review country strategies to support NMCPs and identify best practices
    • Develop a platform to optimize and utilize team expertise across countries

    This report summarizes the meeting, synthesizes best practices and lessons learned from providing technical support to NMCPs and collaborating with stakeholders, and presents a strategy for continued cross-country exchange of expertise and experience.

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    Synthesis of Routine Health Information System Architecture Profiles of the U.S. President’s Malaria Initiative (PMI) Priority CountriesMEASURE Evaluation2019English, , ,

    MEASURE Evaluation developed two-page summary profiles of routine health information systems (RHIS) that capture malaria data in 17 of the countries supported by the U.S. Presidents Malaria Initiative (PMI): Angola, Benin, Burkina Faso, Cameroon, Cte dIvoire, Ghana, Kenya, Liberia, Madagascar, Mali, Mozambique, Niger, Rwanda, Senegal, Sierra Leone, Uganda, and Zambia. Looking across the profiles, this synthesis identifies the commonalities, strengths, challenges, and gaps, and suggests priority areas to focus on further strengthening.

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    Malaria Surveillance: Report on Continuous Medical Education of Health WorkersMEASURE Evaluation PIMA2017English, , ,

    Malaria surveillance is the ongoing, systematic collection, analysis, and interpretation of malaria-related data, which is essential for the planning, implementation, and evaluation of malaria control programming. Malaria surveillance is closely integrated with the timely dissemination of these data for evidence-based malaria prevention and control. Objective 4 of Kenyas National Malaria Strategy states that by the year 2018, all of Kenyas 47 counties should have strong and sustainable monitoring and evaluation (M&E) surveillance systems so that key malaria indicators are routinely monitored and evaluated. Two main surveillance systems are in use in Kenya:

    1. District health information software (DHIS), which takes its name from DHIS 2, the software that runs it: Daily routine facility dataoutpatient and inpatient malaria cases, malaria commodity data, and laboratory dataare consolidated and reported each month to the subcounty health management team that is responsible for the entry of these data in the DHIS.
    2. Integrated disease surveillance and response (IDSR) system: Data on clinical malaria cases, laboratory-tested and positive cases, and malaria-related deaths are collected daily at health facilities and reported weekly in the electronic IDSR system.

    Health workers in targeted counties received a three-day malaria surveillance training from June to July 2016. The training, which used the surveillance training curriculum of the National Malaria Control Program (NMCP), addressed both data producers and data users and aimed to enhance their understanding of and ability to analyse malaria data and their capacity to identify corrective actions needed to improve malaria programming. Emphasis was placed on data analysis, data interpretation, use of tools to facilitate evidence-informed decision making, and integrating data in decision making processes. The data quality audit (DQA) findings, however, showed that the knowledge gained during the training was not fully translated into practice. The NMCP recognized a need for continuous medical education (CME) and facility mentorship visits as a way to institutionalize the objectives of malaria surveillance.

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    Kenya Malaria Programme Review 2018National Malaria Control Programme, Ministry of Health2019English, The Malaria Programme Review (MPR) is a periodic joint programme management process for reviewing the progress and performance of a malaria programme in the context of national health and development plans. It is aimed at improving performance or redefining the programmes strategic direction and focus. In 2009, Kenya conducted a comprehensive MPR of the National Malaria Strategy (NMS) 20012010. The ensuing recommendations led to the development of the NMS 20092017 with its goal set as the reduction of morbidity and mortality caused by malaria by two-thirds of the 2007/2008 levels by 2017. Subsequently in 2014, a mid-term review of the NMS 20092017 was done and this led to some key modifications. First, the initial period of the strategy was extended by one year to 2018 as part of the alignment to the health sector strategy 20132018. Secondly, the strategy was renamed Kenya Malaria Strategy (KMS) 20092018 in line with the devolution of health service delivery roles and responsibilities from national to county governments. Finally, the KMS objectives and strategies were amended for better performance and to align to the devolved status of the health services. The period of the revised KMS 20092018 ends in 2018. The strategy was hence due for an end-term review, which was undertaken in the MPR 2018. The overall objective of the MPR was to undertake an evidence-based review of the country malaria situation and a comprehensive performance review of the KMS against its set targets.tr-19-319
    Malaria Epidemic Preparedness and Response Review and Planning Workshops: January–March 2019Ministry of Health, Republic of Kenya2019EnglishEpidemic preparedness and response (EPR) is one of the key strategic approaches to controlling malaria in Kenya.In collaboration with MEASURE Evaluation, Kenya'sNational Malaria Control Programme (NMCP) organised seven EPR workshops targeting county and sub-county malaria control and disease surveillance coordinators. The workshops were conducted for 127 sub-counties in 26 counties that fell in the epidemic-prone areas of the western highland and seasonal transmission zones. A total of 320 health managers from the 26 counties and 127 sub-counties were trained. For the first time, the 2019 EPR planning and review workshops included sub-county malaria control and disease surveillance coordinators. The evaluations conducted during the workshops revealed important gaps in overall EPR training and monitoring. The workshops resulted in several recommendations to improve future EPR planning and review workshops and epidemic monitoring across all levels.ws-19-56
    Guidelines for Core Population Coverage Indicators for Roll Back Malaria: To Be Obtained from Household SurveysRoll Back Malaria, WHO, UNICEF, MEASURE Evaluation2004English,

    An effective system for monitoring progress and evaluating results is critical for assessing the success of the Roll Back Malaria (RBM) partnerships technical strategies. To facilitate this process, the RBM partners established a set of core indicators for population coverage that can be collected through household surveys that permit national-level monitoring of these technical strategies. The purpose of this manual is to provide country partners with technical guidance on the detailed specifications of the core indicators for population coverage that can be measured through household surveys, the data required for their construction, as well as issues related to their interpretation. Details of the data collection methods required for estimating these indicators through national-level household surveys are also provided. Developed by the RBM partnership, World Bank, the United Nations Childrens Fund (UNICEF), and MEASURE Evaluation, this manual is intended to maximize internal consistency and comparability of the indicators across countries and over time, and to ensure consistency in the types of data collection methods used.

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    Malaria Surveillance and Response: A Comprehensive Curriculum and Implementation Guide2013English, , ,

    The Division of Malaria Control (DOMC) in Kenya has been in the process of operationalizing the WHO Manual for Surveillance in endemic settings. The DOMC has so far realized the adoption of common indicators and dashboards for malaria program monitoring. With the aim of determining whether the data required for malaria surveillance indicators exists at the national, sub-national (district and health facility) level a series of international and national consultative workshops were held, a gap analysis of the existing systems carried out and a pilot of malaria surveillance data collection tool conducted in selected districts.

    In this regard, the DOMC has developed the curriculum to train health workers on how to carry out an effective malaria surveillance at all service levels in the awareness that surveillance systems consists of tools procedures, people and structures which are required to generate information for planning, monitoring and evaluating malaria programs.

    This resource presents the foundation of the curriculum and implementation guide, showing detailed front matter, the module titles, objectives, and content. Access a related trainer's manual and participant's manual.

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    Malaria Surveillance and Response: A Comprehensive Curriculum and Implementation Guide Trainers Manual2013English, , ,

    The Division of Malaria Control (DOMC) in Kenya has been in the process of operationalizing the WHO Manual for Surveillance in endemic settings. The DOMC has so far realized the adoption of common indicators and dashboards for malaria program monitoring. With the aim of determining whether the data required for malaria surveillance indicators exists at the national, sub-national (district and health facility) level a series of international and national consultative workshops were held, a gap analysis of the existing systems carried out and a pilot of malaria surveillance data collection tool conducted in selected districts.

    In this regard, the DOMC has developed the curriculum to train health workers on how to carry out an effective malaria surveillance at all service levels in the awareness that surveillance systems consists of tools procedures, people and structures which are required to generate information for planning, monitoring and evaluating malaria programs.

    This trainer's manual presents the sample pretest and post test questions for the course. Access the related curriculum and implementation guide and participant's manual.

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    Malaria Surveillance and Response: A Comprehensive Curriculum and Implementation Guide Participants Manual2013English, , ,

    The Division of Malaria Control (DOMC) in Kenya has been in the process of operationalizing the WHO Manual for Surveillance in endemic settings. The DOMC has so far realized the adoption of common indicators and dashboards for malaria program monitoring. With the aim of determining whether the data required for malaria surveillance indicators exists at the national, sub-national (district and health facility) level a series of international and national consultative workshops were held, a gap analysis of the existing systems carried out and a pilot of malaria surveillance data collection tool conducted in selected districts.

    In this regard, the DOMC has developed the curriculum to train health workers on how to carry out an effective malaria surveillance at all service levels in the awareness that surveillance systems consists of tools procedures, people and structures which are required to generate information for planning, monitoring and evaluating malaria programs.

    This participant's manual presents PowerPoint presentationsused for all modules of the course. Access a relatedcurriculum and implementation guideandtrainer's manual.

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    Indicateurs basés sur les enquêtes auprès des ménages pour la lutte contre le paludisme2018FrenchLe but de ce manuel est de fournir des spécifications détaillées pour les indicateurs de contrôle du paludisme qui peuvent être mesurés à travers les enquêtes auprès des ménages et les données nécessaires à leur construction, ainsi que les problèmes liés à leur interprétation. Des détails sur les méthodes de collecte de données requises pour estimer ces indicateurs au moyen d'enquêtes nationales sur les ménages sont également fournis. Ce manuel vise à optimiser la cohérence interne et la comparabilité des indicateurs et des types de méthodes de collecte de données utilisés dans les pays et dans le temps.ms-13-78-fr
    Quick Country Start-Up Package for Malaria Surveillance, Monitoring, and Evaluation TrainingMEASURE Evaluation2019English, , , , ,

    Since 2010, MEASURE Evaluation has offered a suite of trainings to contribute to the strengthening of country-level malaria surveillance, monitoring, and evaluation (SME) systems. These trainings are supported by the United States Agency for International Development (USAID) and the U.S. Presidents Malaria Initiative (PMI) and endorsed by the Roll Back Malaria Monitoring and Evaluation Reference Group (RMB MERG). Activities include annual regional malaria SME workshops in English and French, customized country-specific malaria SME workshops, and online malaria SME courses in English and French.

    After 10 years of implementation, there is a need for MEASURE Evaluation to document the process based on lessons learned and provide countries with a reference document for implementing these trainings. Furthermore, as the project comes to a close, the reference document will serve as a quick startup guide for future country malaria SME workshop implementation, including step-by-step approaches, practical tools, and trouble shooting.

    Read a related blog post.

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    Fact Sheet: M&E of Malaria Control Programs: Building Capacity through Regional Workshops2014English, ,

    MEASURE Evaluation and implementing partners, Centre de Recherche en Sant de Nouna (CRSN), Burkina Faso and University of Ghana School of Public Health (UGSPH), Ghana, implemented regional Anglophone and Francophone workshops from 2010 to 2014 to strengthen capacity in the monitoring and evaluation (M&E) of malaria, in response to increased funding for malaria control programs in sub-Saharan Africa and a need for strong information system support to inform malaria program planning.

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    The Importance of Gender in Malaria DataMEASURE Evaluation2017English, , , ,

    The demand for specific data and indicators incorporating a gender perspective has moved beyond advocates of the rights of women and key populations to include decision-makers at every level and in every area of social and economic development. And while there is greater general awareness of the need for a gender perspective in health policy and programming, not all health areas have considered gender implications equally.Addressing gender when monitoring and evaluating malaria projects helps ensure equity in access and benefits for men and women. This brief explores the importance of gender in monitoring and evaluation activities and suggests indicators to reveal and explain gender gaps in malaria outcomes.

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    L’importance du genre dans les données sur le paludismeMEASURE Evaluation2018French, L’examen des disparités entre les genres lors du suivi et de l’évaluation des projets de lutte contre le paludisme permet de garantir l’équité en termes d’accès et d’avantages pour les hommes et les femmes. Cette publication analyse l’importance de la dimension de genre dans les activités de suivi et d’évaluation et suggère des indicateurs pour mettre en lumière et expliquer les disparités observées dans ce domaine, s’agissant des résultats obtenus en matière de lutte contre le paludisme.fs-17-205d-fr
    Strengthening Malis Epidemiological Surveillance SystemMEASURE Evaluation2017English, , ,

    Disease surveillance tells health planners the prevalence and potential risk posed by contagious diseases in their countries or regions. Before March 2014, Mali depended on a surveillance center in Guinea for information on emerging diseases, but then that country became the epicenter of the emergence of the Ebola virus disease. This outbreak in West Africa revealed the fragility of health systems in developing countries and the lack of coordination among epidemiological surveillance systems worldwide.

    Today, Mali relies on the Epidemiological Alert System located in-country, where it is regulated by the National Directorate of Health (DNS) through its Division of Prevention and Control of Disease and the divisions epidemiological surveillance unit. The alert system is supported by the National Institute for Research in Public Health (INRSP) to identify diseases with epidemic potential and is accredited by the World Health Organization (WHO).

    Malis national epidemic management strategy is based on a new integrated disease surveillance and response system (IDSR). Epidemiological data are collected weekly and the transmission of information is supported by a radio communication network, telephone, fax, mobile phones, and Internet networks. This new system has many shortcomings, such as a lack of coordination among programs, inadequate technical and financial resources, and a lack of good-quality data available in time for decisions at all levels.

    To address these issues, the Global Health Security Agenda (GHSA) has stepped in to help Mali strengthen its surveillance system so it can better manage and respond to possible epidemics, such as Ebola. GHSA was launched in February 2014 to help make the world safe from infectious disease threats; to bring together nations to make new, concrete commitments; and to elevate global health security as a priority. In Mali, GHSA is using a multisectoral approach that brings together several partners to improve the system.

    Since January 2016, the U.S. Agency for International Development (USAID), through MEASURE Evaluation, has supported GHSAs effort by providing technical assistance to the DNS to improve the collection, analysis, and availability of epidemiological information in real time. This initiative encompasses 435 community health centers (CSCom) in 19 health districts in the Kayes, Koulikoro, Sikasso, and Bamako regions, near Conakry, Guinea.

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    Global Progress in Malaria Control 2010–2015MEASURE Evaluation2017EnglishThe theme for the World Health Organizations (WHO) World Malaria Day 2017 is Ending Malaria for Good. The world has made great strides in combatting malaria, moving from widespread prevalence across continents to a point today where the fight is waged in smaller geographies, often at a case management level. In that fight, individuals who test positive for malaria infection are treated along with members of their householdsthe goal being to preserve their health and to stop transmission of the disease to their families and associates. MEASURE Evaluation, funded by the U.S. Agency for International Development (USAID), has been a partner in combatting malaria for decades; our work on health information systems and the improved use of data is at the front line of battle. As cases decrease and geographies shrink, health workers rely even more on data to determine who may be infected and if they have accessed treatment. In this infographic, MEASURE Evaluation graphically depicts the encouraging story from WHO of how malaria manifests now across the globe.gr-17-001
    Gender Differences in the Use of Insecticide-Treated Nets After a Universal Free Distribution Campaign in Kano State, Nigeria: Post-Campaign Survey ResultsGarley AE, Ivanovich E, Eckert E, Negroustoueva S, Ye Y.2013English

    Background

    Recent expansion in insecticide-treated net (ITN) distribution strategies range from targeting pregnant women and children under five and distributing ITN at antenatal care and immunization programmes, to providing free distribution campaigns to cover an entire population. These changes in strategy raise issues of disparities, such as equity of access and equality in ITN use among different groups, including females and males. Analysis is needed to assess the effects of gender on uptake of key malaria control interventions. A recent post-universal free ITN distribution campaign survey in Kano State, Nigeria offered an opportunity to look at gender effects on ITN use.

    Methods

    A post-campaign survey was conducted three to five months after the campaign in Kano State, Nigeria from 19 October to 4 November, 2009, on a random sample of 4,602 individuals. The survey was carried out using a questionnaire adapted from the Malaria Indicator Survey. Using binary logistic regression, controlling for several covariates, the authors assessed gender effects on ITN use among individuals living in households with at least one ITN.

    Results

    The survey showed that household ITN ownership increased more than 10-fold, from 6% before to 71% after the campaign. There was no significant difference between the proportion of females and males living in households with at least one ITN. However, a higher percentage of females used ITNs compared to males (57.2%vs 48.8%). After controlling for several covariates, females remained more likely to use ITNs compared to males (OR: 1.5, 95% CI: 1.3-1.7). Adolescent boys remained the least likely group to use an ITN.

    Conclusions

    This study reveals gender disparity in ITN use, with males less likely to use ITNs particularly among ages 1525years. The uptake of the intervention among the most at-risk group (females) is higher than males, which may be reflective of earlier strategies for malaria interventions. Further research is needed to identify whether gender disparities in ITN use are related to traditional targeting of pregnant women and children with malaria interventions; however, results provide evidence to design gender-sensitive messaging for universal ITN distribution campaigns to ensure that males benefit equally from such communications and activities.

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    Improving Estimates of Insecticide-treated Mosquito Net Coverage from Household Surveys: Using geographic coordinates to account for endemicityBurgert CR, Bradley SE, Arnold F, Eckert E2014English,

    Coverage estimates of insecticide-treated nets (ITNs) are often calculated at the national level, but are intended to be a proxy for coverage among the population at risk of malaria. The analysis uses data for surveyed households, linking survey enumeration areas (clusters) with levels of malaria endemicity and adjusting coverage estimates based on the population at risk. This analysis proposes an approach that is not dependent on being able to identify malaria risk in a location during the survey design (since survey samples are typically selected on the basis of census sampling frames that do not include information on malaria zones), but rather being able to assign risk zones after a survey has already been completed.

    The analysis uses data from 20 recent nationally representative Demographic and Health Survey (DHS), Malaria Indicator Surveys (MIS), an AIDS Indicator Survey (AIS), and an Anemia and Malaria Prevalence Survey (AMP). The malaria endemicity classification was assigned from the Malaria Atlas Project (MAP) 2010 interpolated data layers, using the Geographic Positioning System (GPS) location of the survey clusters. National ITN coverage estimates were compared with coverage estimates in intermediate/high endemicity zones (i.e., the population at risk of malaria) to determine whether the difference between estimates was statistically different from zero (p-value <0.5).

    Endemicity varies substantially in eight of the 20 studied countries. In these countries with heterogeneous transmission of malaria, stratification of households by endemicity zones shows that ITN coverage in intermediate/high endemicity zones is significantly higher than ITN coverage at the national level (Burundi, Kenya, Namibia, Rwanda, Tanzania, Senegal, Zambia, and Zimbabwe.). For example in Zimbabwe, the national ownership of ITNs is 28%, but ownership in the intermediate/high endemicity zone is 46%.

    Incorporating this study's basic and easily reproducible approach into estimates of ITN coverage is applicable and even preferable in countries with areas at no/low risk of malaria and will help ensure that the highest-quality data are available to inform programmatic decisions in countries affected by malaria. The extension of this type of analysis to other malaria interventions can provide further valuable information to support evidence-based decision-making.

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    Equity Trends in Ownership of Insecticide-Treated Nets in 19 sub-Saharan African CountriesTaylor, C, Florey, L, and Ye, Y2017English, , , ,

    Malaria disproportionatelyaffects poor, rural populations, with pregnant womenand young children at highest risk. The Roll Back Malaria Partnership, togetherwith the Secretary-General of the United Nations, launchedthe initiative Cover The Bed Net Gap to achieve the goal ofuniversal bed-net coverage by December 2010.

    Finding that previous distribution strategies had led to inequity in insecticide-treated net (ITN) ownershipamong subgroups, particularly between socioeconomicsubgroups, the Cover the Bed Net Gap initiative shifted the distribution of ITNs fromtargeted distribution to mass distribution campaigns, whichaim to provide one ITNfor every two household members.

    This study assessed the level of equity inbed net ownership before and after the widespread implementationof national ITN distribution strategies in 19 malaria-endemic countries in sub-Saharan Africa.

    The study used data from Demographic and Health Surveys as well as Malaria Indicator Surveys. Surveys conducted prior to the launch of the initiative in 2009 were assigned as baseline surveys, and those conducted between 2009 and 2014 were considered endpoint surveys. The study used both country-level and pooled multicountry analyses. Pooled analyses based on malaria transmission risk, were done by dividing geographical zones into either low- and intermediate-risk or high-risk. A calculation of the Lorenz concentration curve and concentration index (C-index) assessed changes in equity.

    Out of the 19 countries this study assessed, 13 showed improved equity between the baseline and endpoint surveys, and two countries showed no change. Four countries had worsened equity, with two showing greater increases in coverage of poorer households and two showing greater increases in coverage of richer households.

    Findings indicate that bed net distribution campaigns linked to the launch of the Cover The Bed Net Gap initiative, have led to improvement in coverage of ITN ownership across sub-Saharan Africa, with a significant reduction in inequity.

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    Gender and Malaria in KenyaKenya Ministry of Health, Malaria Control Unit2015English, , , This gender and malaria review focuses on the monitoring and evaluation aspects of various documents, strategic plans, and current practices in the path toward a malaria-free Kenya. The report is also available online at https://www.measureevaluation.org/pima/ malaria/gender-and-malaria-in-kenyacl-19-005
    Gender In SeriesMEASURE Evaluation2017English,

    Gender is in family planning, infectious diseases, malaria, HIV/AIDS and other health issues.That means its always important to include gender sensitivity in planning or measuring any health program.

    The demand for specific data and indicators incorporating a gender perspective has moved beyond advocates of the rights of women and key populations to include decision makers at every level and in every area of social and economic development. And while there is greater general awareness of the need for a gender perspective in health policy and programming, not all health areas have considered gender implications equally.

    Gender constructs have a significant impact on a persons health outcomes. Gender expectations shape behaviors and beliefs related to risk and vulnerability. They also affect such health-seeking behavior as testing and treatment adherence. Gender even shapes the way in which health services are structured and provided. These social expectations lead to important differences in risk and service use for men, women, and key populations. For example:
    • Unequal power relationships increase women's vulnerability to HIV by limiting their ability to negotiate sexual relationships and condom use.
    • Tuberculosis progresses more quickly in women of reproductive age than men of the same age group.
    • Women may be more willing than men to invest in malaria-prevention measures such as insecticide-treated bed nets (ITN) but may lack the financial power to do so.
    • Men are often excluded from family planning and reproductive health (FP/RH) services or FP/RH information systems that are tailored for women.
    • Most caregivers of orphaned and vulnerable children (OVC) are female; boys may not be acquainted with positive role models whom they can emulate.
    • Efforts to contain and respond to emerging infectious diseases often divert resources away from routine health services, disproportionately impacting women who seek contraceptives, or maternal health and postnatal care.
    Addressing gender when monitoring and evaluating health projects helps ensure equity in access and benefits for men and women. MEASURE Evaluation's Gender In Series explores the implications of gender on various technical area data and suggest indicators to reveal and explain gender gaps in health outcomes. Access the online collection at https://www.measureevaluation.org/our-work/gender/gender-in-series
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    Toolkit for Integrating Gender in the Monitoring and Evaluation of Health ProgramsJessica Fehringer, Brittany Iskarpatyoti, Bridgit Adamou, and Jessica Levy2017English, , , , , This toolkit aims to help international health programs integrate a gender perspective in their monitoring and evaluation (M&E) activities, measures, and reporting. It is designed for use by health program staff working in various health sectors (such as HIV; malaria; reproductive, maternal, newborn, and child health; and tuberculosis), and for various health agencies and initiatives. The toolkit will support health program staff to integrate gender in their programs, projects, and M&E activities. Its objectives are to provide the following:
    • Processes and tools for integrating gender in a health programs M&E activities
    • Guidance on facilitating communication with primary stakeholders on the importance of gender and M&E
    • Additional resources on gender-integrated programming and M&E
    The full collection is available online at https://www.measureevaluation.org/resources/tools/gender/toolkit-for-integrating-gender-in-the-monitoring-and-evaluation-of-health-programs Access resources from a related webinar.
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    Household Survey Indicators for Malaria Control2013English

    The purpose of this manual is to provide detailed specifications for malaria control indicators that can be measured through household surveys and the data that are required for their construction, as well as the issues related to their interpretation. Details of the data collection methods required for estimating these indicators through national level household surveys are also provided. This manual is intended to maximize internal consistency and comparability of the indicators and the types of data collection methods used across countries and over time.

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    Guidance for Evaluating the Impact of National Malaria Control Programs in Highly Endemic CountriesMortality Task Force of the Roll Back Malaria Partnership's Monitoring and Evaluation Group2014English, In 2007, the Roll Back Malaria Partnership's Monitoring and Evaluation Group (MERG) proposed the use of a plausibility design to measure impact of malaria control programs.Since then, new measurement needs and evidence have emerged, requiring an updated approach. This document reviews and updates the 2007 evaluation framework and provides recommendations for evaluating the scale-up of malaria control interventions in endemic countries.ms-15-100
    Monitoring and Evaluation of Malaria Programs – Online CourseHerrera S, Ivanovich E, Y Y, Garley A2016English, , The main purpose of the course is to describe the fundamental concepts of monitoring and evaluation as they specifically relate to malaria prevention and control programs and to identify the essential components of monitoring and evaluation (M&E) plans for malaria programs. The course will provide a general overview of malaria basics, the scope and important functions of M&E, and an introduction to monitoring and evaluation specifically for malaria programs. The course will walk learners through the essential elements of an M&E plan, including the different M&E frameworks and indicators for malaria programs. Common M&E data sources for malaria programs will be introduced, in addition to the main strengths and weaknesses of these sources. The course will provide an overview of data analysis, interpretation and presentation of malaria-related data. At the end of this course, you will be able to:
    • Describe the fundamental concepts and practical approaches to monitoring and evaluation of malaria programs.
    • Differentiate between monitoring and evaluation and describe the role that evaluation serves.
    • Identify the components of M&E plans for malaria programs and how to prepare one.
    • Describe the different frameworks used in M&E for malaria programs.
    • Identify what a good indicator is and how to develop appropriate indicators for malaria control and pre-elimination.
    • Identify common data sources and systems for malaria programs.
    • Identify appropriate graphs for presenting data.
    Time:  Approximately 4-6 hours Upon successful completion of the course and exam, the student will receive a certificate. The student must receive a passing grade of 80 percent on the final course exam to print the certificate. Each student will have an unlimited number of attempts to achieve the passing grade for the final course exam.
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    Suivi et évaluation des programmes de lutte contre le paludisme – Cours en ligneHerrera S, Ivanovich E, Ye Y, Garley A2016French, , L'objectif principal du cours est de décrire les concepts fondamentaux de suivi et évaluation (S&E) spécifiquement pour les programmes de prévention et de lutte contre le paludisme et d'identifier les composantes essentielles ainsi que les plans de suivi et d'évaluation des programmes de lutte contre le paludisme. Ce cours donne un aperçu sur les concepts fondamentaux de suivi et évaluation des programmes de prévention et de lutte contre le paludisme. Il donne aussi un aperçu général sur les notions de base du paludisme, l’importance et le rôle du S&E, ainsi que les éléments essentiels d’un plan de S&E, les différents cadres et les indicateurs de S&E pour les programmes de lutte contre le paludisme. Nous allons identifier les principales sources de données communes de S&E des programmes de lutte contre le paludisme, leurs forces, ainsi que leurs faiblesses. Le cours donnera aussi un aperçu sur l'analyse, l'interprétation, et la présentation des données relatives au paludisme.

    Objectifs A la fin de ce cours, vous serez en mesure de:
    • Décrire les concepts fondamentaux et des approches pratiques pour le suivi et l'évaluation des programmes de lutte contre le paludisme.
    • Distinguer le suivi de l'évaluation et décrire le rôle de l’évaluation.
    • Identifier les composantes des plans de S&E pour les programmes de lutte contre le paludisme et en préparer un.
    • Décrire les différents cadres utilisés dans le S&E pour les programmes de lutte contre le paludisme.
    • Identifier un bon indicateur, développer des indicateurs appropriés pour le contrôle et la pré-élimination du paludisme.
    • Identifier les sources et les systèmes de données communes pour les programmes de lutte contre le paludisme.
    • Identifier les graphiques appropriés pour la présentation des données.
    Temps Environ 4-6 heures

    Après avoir réussi à l'examen, , l'étudiant recevra un certificat. L'étudiant doit pour ce faire recevoir une note de passage de 80 pour cent au moins à l'examen final pour pouvoir imprimer le certificat. Chaque étudiant aura un nombre illimité de tentatives pour atteindre la note de passage pour l'examen final.
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    Timeliness of Malaria Treatment in Children Under Five Years of Age in Sub-Saharan Africa: A Multicountry Analysis of National Household Survey DataShah JA, Emina JBO, Ye Y2014English, , Malaria is one of the most severe public health problems worldwide, particularly for children under five years of age. The World Health Organization recommends prompt diagnosis and treatment with effective antimalarial medicines within 24 hours of the onset of fever. Delays in treatment can have fatal consequences, particularly if the infection is severe, but few studies systematically assess these delays among children under five years of age in Sub-Saharan Africa (SSA). This study examined the extent to which children under five years of age across SSA received an antimalarial treatment within 24 hours of the reported onset of fever. The study also investigated children under five years of age who received a first-line artemisinin combination therapy (ACT) within 24 hours of the reported onset of fever. Finally, the study identified predictors of prompt treatment with ACT and describes profiles of children who received this recommended treatment. The study focuses on the following countries prioritized by the United States Presidents Malaria Initiative (PMI): Angola, Benin, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Rwanda, Senegal, Tanzania mainland, Uganda, Zambia, and Zanzibar.sr-15-119
    Routine Health Information System Rapid Assessment Tool: Implementation GuideMEASURE Evaluation2018English, , , The World Health Organization (WHO) and MEASURE Evaluation funded by the United States Agency for International Development (USAID) have identified and harmonized standards for data management of the routine health information system (RHIS). The standards, which are best practices, promote the production of timely, accurate data for use in program planning and monitoring and evaluation (M&E). The RHIS Rapid Assessment Tool was developed to assist health information system (HIS) managers and evaluators identify gaps and weaknesses aspects of health facility and community information systems that do not meet the standard with a view to strengthening the RHIS and improving the data. The RHIS Rapid Assessment Tool compares a country's RHIS to the global standards and indicates where resources should be invested to improve the system. Access the tool's Data Entry Module and Analysis and Dashboards Module.tl-18-10a
    Stakeholder Data Use and Dissemination Planning Tool: An Example from a Research Study in Haiti: Final ReportMEASURE Evaluation2019English, , , , An essential component of any public health research study is the effective translation of scientific findings into knowledge used by policy makers, practitioners, and other scientists. Effective knowledge translation is important to avoid the know-do gap, where useful scientific results fail to link to policy or programmatic action. The engagement of stakeholders by researchers is a process that can help prevent the know-do gap. Within the established steps of stakeholder engagement, fostering interaction among stakeholders about data use early in the project life cycle helps researchers plan for the effective dissemination of findings. This brief presents a tool that is administered during study sensitization meetings with stakeholders. Its purpose is to elicit the information needed to develop an effective data use and dissemination plan.tl-19-24
    Assessment of the Effectiveness of Malaria Monitoring and Evaluation Regional Workshops and Online Training CourseMEASURE Evaluation2015EnglishSubstantial investments have been made in the last decade to improve the quality of services and coverage of major malaria control interventions and accelerate progress toward malaria elimination. As these investments continue and grow, sound programmatic decisions require strong monitoring and evaluation (M&E) systems to document progress in malaria control and ensure accountability of resources invested. In sub-Saharan Africa (SSA), the challenges M&E systems face sometimes impede efforts for generating evidence needed for informed decision making. In addition to the limited financial resources that malaria M&E systems in SSA face, they also must deal with poor access to technology and a lack of personnel with the required M&E knowledge and skills. Consequently, the quality of data generated by existing M&E systems has been questionable. MEASURE Evaluation has been a significant supporter for M&E systems of national malaria control programs. One means of support has been MEASURE Evaluations efforts to strengthen malaria M&E capacity by offering M&E training targeting mainly M&E professionals who work on malaria at national, regional, and district levels; professionals who work on USAID projects; and employees of nongovernmental organizations (NGOs). The training has been through in-person regional workshops and online training courses. The two-week intensive in-person workshop format was used from 2010 to 2014 in annual workshops in Ghana (Anglophone) and Burkina Faso (Francophone). To identify strengths, weaknesses, and areas that need improvement, MEASURE Evaluation undertook an assessment of the in-person workshops and online training course. This report provides the results of the training program evaluation, based on information from participants surveys at the in-person workshops, participants supervisors or referees who supported participants application to attend the M&E training course, and other stakeholders interested in malaria M&E. Additional information came from users of the online training course who did not complete the end-of-course certification exam and students who completed the online course and examination. MEASURE Evaluation and USAID PMI will use this assessment to guide the design and implementation of future malaria M&E training programs.tr-15-120
    Guidelines for Integrating Gender into an M&E Framework and System AssessmentMEASURE Evaluation2016English, , This document offers concrete guidance on how organizations can comprehensively and explicitly integrate gender in their monitoring and evaluation (M&E) systems. It describes how to make each component of a functioning M&E system gender-sensitive and provides guidance on how to assess an M&E system to ensure that gender is fully integrated throughout the system for appropriate collection, compilation, analysis, dissemination, and use of gender data for decision making. This document outlines why it is important to apply a gender lens to M&E processes and structures and contextualizes gender in an M&E system. It then walks you through how to think about gender and address it in each of the components of an M&E system. This guide includes examples of gender-specific assessment questions that can be integrated in an M&E system assessment and provides guidance on how to plan and conduct an M&E system assessment. This guidance document is intended for national health program and M&E managers, subnational health program staff with M&E responsibilities, M&E officers from different agencies or organizations, and development partners who provide M&E support to national and subnational M&E systems.tr-16-128-en
    Data Use in the Democratic Republic of the Congos Malaria Program: National and Provincial ResultsBrodsky I and Nyanzi I2017English

    Evidence-informed decision making is essential for the success of health systems, programs, and services. Global commitments to improving health systems and outcomes have led to improved monitoring and evaluation and health information systems, thus providing an opportunity to use data for decision making and not simply for reporting. Overall, the relationships among improved information, demand for data, and continued data use constitute a cycle that leads to improved health programs and policies. Improving data demand and use is necessary to improve the effectiveness and sustainability of a health system.

    MEASURE Evaluation, funded by USAID and the United States Presidents Malaria Initiative (PMI), undertook an assessment to understand the data-use context for those working in the Democratic Republic of the Congo in the National Malaria Control Program and the Division du Systme National d'Information Sanitaire (DSNIS, or Division of the National Health Information System), as well as in Haut Katanga, Kinshasa, and Lualaba provinces. The purpose of this assessment was to identify how data are currently being used for decision making and how future interventions can be designed to promote the demand for and use of data in decision making.

    This mixed-methods assessment was based on MEASURE Evaluations conceptual approach and logic model, which provides guidance on best practices in data-informed decision making and data use. The model looks at three determinants of data use: technical, organizational, and behavioral. These determinants are adapted from the Performance of Routine Information Systems Management (PRISM) framework developed by Aqil, et al. (Aqil, et al., 2009). The assessment used four tools to assess an organizations data-use capabilities, as well as key barriers to and facilitators for developing and sustaining a culture of data use.

    This report shares the methods and findings of the assessment and recommendations for agencies in the DRC for the use of data in their decision-making processes.
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    Assessment of Malaria Interventions in Four Nigerian States: Final ReportMEASURE Evaluation, National Malaria Elimination Programme, and the Presidents Malaria Initiative2017English, , In 2014, Nigeria reported more than 7.8 million confirmed cases of malaria and more than 6,000 malaria-related deaths. The National Malaria Elimination Programme of the Federal Ministry of Health, in collaboration with partners, has been working to significantly expand key malaria control interventions. Nigeria became a Presidents Malaria Initiative (PMI) country in 2010, and PMIhas been a key partner in the governments efforts to expand malaria control intervention coverage. Efforts have focused on insecticide-treated nets, targeted indoor residual spraying, intermittent preventive treatment in pregnancy, and effective case management. In 2015, PMI requested MEASURE Evaluation, a project funded by the United States Agency for International Development (USAID) and PMI, to assess the progress of malaria interventions and outcomes in Cross River, Ebonyi, Nassarawa, and Sokoto States between 2008 and early 2016. The main aim of the assessment is to provide information to guide and streamline future PMI support and strategies for malaria control and elimination in Nigeria. The malaria intervention assessment used a mixed-methods approach, consisting of secondary data collation, primary data collection, document review, and secondary analysis of existing household survey data. This report provides recommendations for each examined component area based on the assessment's key findings.tr-17-191_en
    Factors Affecting Sex- and Age-Disaggregated Data in Health Information Systems Lessons from the FieldMEASURE Evaluation2017English, , , , , , , Gender is a central component of health equity and must be examined and addressed explicitly in health information systems (HIS) through sex and age-disaggregated data, at a minimum, and ideally, through gender-sensitive data, as well. The data that HIS produce can perpetuate inequalities or promote health equity. When sex and age are not acknowledged and addressed in HIS, gender norms and inequalities that influence health and health-seeking behaviors remain invisible. Disaggregated data allow program managers and decision makers to examine service-delivery, treatment, and health-outcome data in depth, so that they can detect differences between the sexes, age groups, and key populations. MEASURE Evaluation, funded by USAID and the United States Presidents Emergency Plan for AIDS Relief (PEPFAR), has compiled evidence from desk reviews and key informant (KI) interviews in Kenya, Tanzania, and Zambia to illustrate trends and challenges in the collection and use of sex- and age- disaggregated HIS data and provides recommendations to move the field of global health forward.fs-17-215
    Standard Operating Procedure for Integrating Gender in Monitoring, Evaluation, and ResearchMEASURE Evaluation2018EnglishGender-related issues permeate culture and its institutions, often leading to health inequities for everyone. Gender inequalities affect health outcomes and program implementation, and ultimately the success of programs. Public health information systems must identify sex-specific trends and provide information needed to eliminate inequities, but gender integration in monitoring, evaluation, and research goes beyond just sex-disaggregated data. The purpose of this standard operating procedure (SOP) is to clearly identify ways to account for gender equality as part of monitoring, evaluation and research activities from planning and budgeting to implementation and dissemination.fs-17-247b
    Decision Support Tools for Malaria Prevention and TreatmentMassoud Moussavi, PhD; Kent W. Lewis, MA; Vilas Mandlekar, MBA, MS; Aminata Y. Sallah, MBChB; Tajrina Hai, MHS; and Yazoum Y, PhD2017English, , Malaria-endemic countries have experienced a significant decline in malaria burden in recent years, and they are relying on strong health management information systems to provide good-quality data to track progress and measure program achievements. The DHIS2 software platform has been rolled out in several countries to collect, validate, report, analyze, and present aggregated statistical data using a dashboard for the health systems operations. However, DHIS2 falls short in providing guidance to program managers on high-priority actions and the potential impact of those actions. MEASURE Evaluation conducted a literature review to identify decision support tools, synthesize their strengths and weaknesses, and assess gaps. The research team searched databases of peer-reviewed and gray literature for decision support tools for malaria control. The reference databases and digital libraries included MEDLINE (via PubMed), Google Scholar, and SCOPUS. In addition, the team performed online searches of websites and online publications to identify decision support tools developed by specific organizations. The research team found 11 decision support tools related to malaria prevention and treatment. Each of these tools focuses on different interventions and outcomes, with some tools focusing on multiple interventions and others focusing on a single intervention. This review covers the 11 tools for malaria prevention and provides recommendations for developing a new tool to address operational and implementation challenges facing subnational decision makers.tr-17-219