Case-based Reporting and Analysis to Enhance the Value and Use of Routine Health Facility Data for Health Policy, Programming and Research: Case Study of a New Malaria Surveillance System in The Gambia
thesisposted on 2021-01-27, 08:46 authored by Samuel Emetu Anya
A sustained decline in the burden of malaria from 2003 to 2007 in The Gambia
highlighted the need for real-time data to monitor the changing epidemiology of
malaria. The aim of the studies described in this thesis was to determine the
value and use of routine case-based health facility data for malaria policy,
programming and research.
To achieve this aim, individual, rather than aggregate, malaria case records at
the six sentinel sites were analysed by age, sex, month, season and location.
The impact of malaria on anaemia was analysed at individual and population
levels. Malaria data from one of the sentinel sites and from village health
workers in the catchment community were compared. The use of data was
investigated through 31 key informant interviews and document review.
Quantitative and qualitative data were analysed in R. A CATWOE analysis was
done to characterise health system strengthening barriers and facilitators.
Case-based analyses revealed previously unreported age and sex distributions
of malarial illness. Young children had the lowest rates of malaria parasitaemia
but highest rates of severe anaemia if they had malaria. However, at population
level, the prevalence of malaria-attributable severe anaemia was less than 2%
in all age groups. Health facility malaria data were representative of malarial
illness in the community despite small-area heterogeneity. The availability and
use of surveillance data led to changes in malaria policy, programming and
design of surveys.
Case-based reporting is feasible and enhances the value and use of routine
health facility data as it enabled a depth and breadth of analysis that is not
possible with aggregated data. Changes to WHO recommendations on malaria
reporting are required to facilitate the adoption of case-based reporting in
malaria control settings. Systems thinking is required to ensure that actions and
capabilities required to generate, report, analyse and use data are clarified and
First SupervisorProfessor Samuel McConkey
Second SupervisorProfessor Ruairi Brugha
CommentsA thesis submitted for the degree of Doctor of Philosophy from the Royal College of Surgeons in Ireland in 2020.
Published CitationAnya SE. Case-based Reporting and Analysis to Enhance the Value and Use of Routine Health Facility Data for Health Policy, Programming and Research: Case Study of a New Malaria Surveillance System in The Gambia[PhD Thesis]. Dublin: Royal College of Surgeons in Ireland; 2020.
Degree NameDoctor of Philosophy (PhD)
Date of award2021-11-30
- Doctor of Philosophy (PhD)