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Evaluation of Malaria Surveillance in Ghana, 2009
Background: Malaria is a life-threatening disease transmitted by mosquitoes. Globally it infects between 300-500 million people annually causing nearly one million deaths, mostly among African children. In 2008, 31.1% of all outpatient illnesses and 30.3% of deaths in children under-five years in Ghana was due to malaria mostly caused by Plasmodium falciparum. As part of its efforts to strengthen programme monitoring and evaluation the National Malaria Control Programme has an objective to improve surveillance data management.
Methods: Selection of study areas was done by convenient sampling and the CDC guidelines for evaluating public health surveillance systems were applied. In-depth interviews, observation and desktop reviews were also employed in data collection.
Results and Discussion: The malaria surveillance system of Ghana has three passive and health facility-based components, namely; a vertical malaria surveillance (VMS) system, an integrated disease surveillance response (IDSR) systems and an electronic district health information management system (DHIMS) with estimated sensitivity of 7.0%, 7.5% and 6.6% respectively. In 2008, the predictive value positive for all malaria cases was estimated as 39.2%. The VMS ranked lowest in terms of timeliness and completeness of reporting. All the surveillance systems were simple, flexible and useful but their representativeness was undermined by poor coverage of private health facilities.
Conclusion: Although the VMS is the main national source of malaria reference data, its performance was either below or at par with the other two surveillance systems. The full potential of the DHIMS is not being realised because of inadequate collaboration among stakeholders. A complete review of all malaria surveillance systems in Ghana by stakeholders will be required to streamline operations to enhance timeliness of reporting and reduce unnecessary workload.
Keywords: Malaria, surveillance, monitoring, Africa, Ghana
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