A Cross-cutting Issue for Malaria Elimination Programme in Nigeria.
The Monitoring and Evaluation mechanism for the National Malaria Elimination Programme in Nigeria is designed to cover all control interventions such as prompt and effective case management including
home-based care, Integrated Vector Management including use of LLINs, Intermittent Preventive Therapy of malaria in pregnancy, Procurement and Supply Chain Management and communication for behaviour change.
Framework for Monitoring and Evaluation:
The M&E branch collects, collates and analyzes malaria data, as well as develop new knowledge through operations research to generate evidence upon which policy decisions are taken in relation to options
for programme implementation.
System for disease surveillance and resistance monitoring
Malaria surveillance is carried out within the confines of the National Health Management Information System (NHMIS) and in conjunction with the Epidemiology Division of the Department of Public Health, Federal Ministry of Health. Data is generated from health facilities in all local government areas through the Disease Surveillance and Notification (DSN) system.
NMEP also has 14 sentinel sites located throughout the six geopolitical zones of the country. These are being repositioned not only to serve as research centers for drug efficacy trials and
parasite and vector resistance monitoring centers; but as malaria surveillance centers.
Periodically, population-based surveys are conducted, using standardized tools such as the Malaria Indicator Survey (MIS) tools, to evaluate programme implementation vis-à-vis set targets. The schema
below shows the framework for NMEP M&E.
Organizational Body Responsible for Data Collection
Data from all health facilities (public and private) are collected by the records unit of the health facilities, collated and summarized by DSN Units of each local government health department and reported during DSN Officers' monthly meeting with the State Epidemiologist. State summaries are sent to the National Epidemiologist and shared with different disease control programmes. Development and Health Partners including Bi - and Multi- laterals International and National NGOs, Research Institutions contribute and facilitate data management at all levels. WHO plays a key role in the generation and management of public health data in Nigeria using the IDSR.
Type of Data
Routine and periodic data collection is done using standardized tools e.g. harmonized NHMIS tools and IDSR Forms, disease information are collected on basis. Malaria information is collected using IDSR 003 (Routine Monthly Notification Form) alongside other 22 notifiable diseases including the new addition, Avian Influenza virus. Specific malaria information collected include number of out-patient cases, in-patient cases and deaths in age ranges less than five, 5 - 14 and 15 years and above .
Frequency Of Data Collection
A monthly reporting system for malaria is in practice in Nigeria. The frequency of reporting is however, often affected by the deficiency in capacity, inadequate resources, poor communication and transmission of data from health facilities at State and LGA levels.
Utilization Of Data
At each level of data collection, information is used for decision making in Policy formulation/review, advocating for resources, planning and reprogramming. Information is also shared with the higher levels with a feedback mechanism that goes down to the lowest level which usually takes place during supervisory visits, DSNO and IDSR Stakeholders' meetings. The Epidemiology Division of the FMOH works closely with the NHMIS in all health data generation and analysis