29 Jan 2020

Luminare: Insights from a Malaria Consultative Meeting in Malawi

This blog post is part of Luminare, our blog series exploring innovative solutions to data collection, quality assurance, biomarker measurement, data use, and further analysis.


The DHS Program clearly loves data, but what good is collecting data if it is not used, or used only in isolation? This was the motivation behind a Malaria Data Consultative Meeting implemented by The DHS Program and co-facilitated by Dr. Katherine Battle of the Malaria Atlas Project in Malawi in July 2019.

Routine health surveillance data are continuously collected at health facilities in Malawi and entered into District Health Information Software 2 (DHIS2), giving a robust picture of malaria control in Malawi. For instance, each year, approximately six million malaria cases account for 30% of all outpatient visits at health facilities, 34% of inpatient hospital admissions, and 2,967 malaria-related hospital deaths.

The quality and completeness of DHIS2 data vary by facility and only data on people who seek and receive care are included. By contrast, household surveys, such as Demographic and Health Surveys (DHS) and Malaria Indicator Surveys (MIS), are representative of the general population, with comparable data for trend analysis and multi-country comparisons.

At the consultative meeting, malaria data experts developed and presented case studies on indicators that were found in both data sources to check for external consistency and evaluate progress towards Malawi’s Malaria Strategic Plan (MSP) targets. For instance, effective malaria case management is a key component of the 2017–2022 MSP, with targets to test 95% of suspected malaria cases and treat 100% of confirmed cases by 2022.

The DHIS2 data above depicts suspected malaria cases in children under 5 that received a confirmatory test at a health facility. The household survey data above represents children under 5 who had a fever in the previous 2 weeks for whom advice or treatment was sought and who had blood taken from a finger or heel for diagnostic testing. See the table below for more information on these indicators.

 
Data sourceAvailable dataIndicatorNumeratorDenominator
DHIS22014–2018Percent of suspected malaria cases in children under 5 who received a confirmatory test at facility or village clinicNumber of suspected malaria cases in children under 5 who received a confirmatory testTotal number of suspected cases in children under 5 at facility or village clinic
Household survey data2014 Malawi MIS and 2017 Malawi MISPercent of children under 5 with fever in the previous 2 weeks for whom advice or treatment was sought and who had blood taken from a finger or heel for testingNumber of children under 5 with fever in the previous 2 weeks for whom advice or treatment was sought and who had blood taken from a finger or heel for testingTotal number of children under 5 with fever in the previous 2 weeks for whom advice or treatment was sought

Adapted from Table 2 in Malaria Journal report.

Both the DHIS2 and MIS data show improvement in confirmatory testing of suspected cases over time, although absolute values differ. Differences were attributed to recall bias among survey respondents. Because the study populations (denominators) of the two datasets are different, it is more meaningful to compare trends rather than absolute values.

As countries move towards malaria elimination it is essential that programs begin monitoring performance using multiple data sources. By using routine surveillance data and household survey data together, malaria data experts have a more complete, unbiased picture of malaria in Malawi.

A report of this Malaria Data Consultative Meeting was published in the Malaria Journal. You can read it here!

Explore Malawi household survey data for yourself using STATcompiler.




 

Featured image caption: Participants from the Malaria Data Consultative Meeting in Malawi. ©ICF

07 Jan 2020

Introducing DHS Program Analysis Briefs

Over the last 30 years, The DHS Program has published more than 500 analytical reports in collaboration with researchers and institutions around the world. These reports extend to a wide variety of topics covering population and health issues with the ultimate purpose to be used in policy formation, program planning, and monitoring and evaluation. However, many potential beneficiaries of DHS Program research findings are intimidated by these long, technical reports.

In order to expand the reach of DHS analyses to program managers, policymakers, and academic researchers, The DHS Program is pleased to announce a new user-friendly format of analysis reports. Analysis Briefs are two- to three-page user-friendly documents summarizing the methods, key findings, and any relevant action steps.

 

Featured image: © ICF

These abbreviated, colorful briefs with graphics highlight major findings in a more accessible way that allow readers to use the findings for program or policy use in their respective country. If readers choose to dive into the full report, the brief still provides an orientation through the technical data in the full report. The graphics are presented in a simplified way to orient the information in a clear, visual display. Readers with limited time and attention are encouraged to review the accompanying briefs for a condensed summary of the full analysis report.

Briefs can be found on the full report publication summary page or by filtering by publication type ‘Analysis Briefs’ in The DHS Program publication search.

 

The information provided on this Web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.

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Anthropometry measurement (height and weight) is a core component of DHS surveys that is used to generate indicators on nutritional status. The Biomarker Questionnaire now includes questions on clothing and hairstyle interference on measurements for both women and children for improved interpretation.