Current situation of M

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Current situation of ME in EMR

• Dr Hoda Atta
• RA/RBM/EMRO

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MONITORING AND EVALUATION

• ME is the cornerstone of any disease control
  programme
• ME is critical for planning, assess the progress
  towards achieving the stated objectives.
• identify areas where modifications may be needed
  in relation to the intervention strategies
• allocation of resources at national,
  sub-regional, regional and global levels.

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ME for Reporting RBM progress

• the RBM global objective (50 reduction of
  malaria burden, morbidity and mortality impact,
  by 2010)
• the Abuja targets (60 coverage of malaria
  treatment and prevention interventions by 2005)
• the Millennium Development Goal related to
  malaria (Goal 6, Target 8) have halted by 2015
  begin to reverse the incidence of malaria
• achieving the targets stated in the Global Fund
  application

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Reporting on Malaria core indicators

• Despite the extensive variation of malaria
  epidemiology between and within sub-regions and
  countries, RBM has proposed five global
  indicators. Malaria endemic countries should
  report on such indicators wherever apply.
• 1) Malaria death rate (probable and confirmed
  cases) among target groups (under-five and other
  targets groups)
• 2) Number of malaria cases, severe and
  uncomplicated (probable and confirmed) among
  target groups (under-five and other target
  groups)
• 3) Proportion of households having at least one
  treated bednet
• 4) of patients with uncomplicated malaria
  getting correct treatment, within 24 hours of
  onset of symptoms and
• 5) of health facilities reporting no disruption
  of stock of antimalarial drugs for more than one
  week during the previous three months.

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MDGs related to malaria

• MDGsList_smartformat.pdf

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Background- M E at global level

• External evaluation and assessment of the status
  of the Roll Back Malaria monitoring system was
  done in 2002
• Results
• Lack of focus in ME indicators,
• inconsistent definition of indicators
• Lack of guidance on assessing malaria indicators
• Present capacity in ME at the global, regional
  and country level is very weak
• lack of good quality data in the RBM programme.

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RBM external evaluation recommendation on ME

• This evaluation recommended the establishment of
  a strong monitoring and evaluation team at the
  global and regional level and improvement of the
  methodologies for different aspects of
  information generation from data collection to
  report production.

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Activities to strengthen ME-global level

• Monitoring and Evaluation Reference Group (MERG)
  has been established
• Africa malaria report was published in 2003
• Global report will be published very soon
• Establish a complete malaria database at the
  global level

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CURRENT MALARIA INFORMATION SYSTEM IN EMR

• Many challenges
• Notifications on mortality and morbidity
  received from countries are incomplete and of
  poor quality
• Lack of reliable estimates -
• the burden is estimated at 15million case /year
  since some time ago, estimation method in the
  countries is not clear, efficient estimates are
  not developed
• Global health report 2003 showed an increase in
  malaria mortality in EMR in the last years , is
  this true?? What about the progress reported in
  Yemen and Sudan
• No system for measuring outcomes yet established

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Strengthening ME in EMR- ongoing activities

• provision of SE for data management
• support laboratory-based sentinel surveillance,
• support for the use of GIS in several countries
• support establishing sentinel sites for
  monitoring drug and insecticide resistance, and
  establishing networks (HANMAT, EMNVR)
• Support malaria surveys in AFG , SOM
• Recruitment of staff in EMRO for ME
• support national ME workshop in Sudan , 2004
• Organising this workshop for malaria endemic
  countries
• Revised malaria surveillance form

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Strengthening ME in EMR- planned activities

• Support research for estimation of malaria burden
  
• National ME workshops
• Regional malaria report
• Regional malaria data base linked to health
  mapper
• RBM web site-special channel on ME
• IC Workshop for countries with free/limited
  transmission
• Support national workshops for ME
• Arabic and Farsi versions of Healthmapper is
  under development
• including malaria coverage indicators in HH
  surveys (Sudan started)

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Conclusion

• With the current weakness in HIS, we can not
  report on our progress toward achievements of
  MDGs, Abuja targets, RBM objectives
• Establishing an efficient ME system should be a
  priority of MCP , in integration with HIS ,
  resources should be allocated, capacity should be
  built