Malaria Indicator Training Workshop FAQs

1. Questions and Answers(FAQ) RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

2. Materials • Please use your CD where plenty of information is available to facilitate your work on MIS. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

3. MIS Planning Start of the planning • Planning must start several months before training for field work begins. • Obtaining agreement within the MOH and local partnership needs time. • Before field work there is need for months of lead time. Partnership involvement and meetings • Once MOH decides to conduct MIS implementing partners in malaria, CSO should co-opted into the process soonest. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

4. MIS Planning MIS Coordinating Team • A MIS Core Team must be formed. Team composition should be inclusive but effective • Team should have regular meetings. • Determine key indicators Protocol Development • The Core team will develop a MIS protocol which will be submitted for ethical approval to the appropriate national body at minimum. Samples in folder. • Discussion of survey procedures is necessary. • Need for a focal point person for the MIS to be responsible on a daily basis. • Easier to approve if it is classified as an evaluation of a programme than when classified as a research. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

5. MIS Planning Obtaining Ethical Clearance • Once protocol is developed a small group should take charge of the ethical clearance issues as work continues on the various aspects of MIS preparations. • As indicated above, MIS should be classified as an evaluation of a programme. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

6. MIS Planning Developing a sampling frame with PDAs and GPS • Use of PDA and GPS is the future. • Need for standardising software and capacity building in programming of PDAs. • NMCP/MOH and CSO should nurture a relation on MIS since CSO will be required form conception to report writing. • Need to iron out the questionnaires and software including errors in advance of training of enumerators. • Pretesting of software should also be done before training of enumerators. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

7. MIS Planning Working with the CSO on sampling and maps • Need to speak the CSO language so that it fits into their system. Bear in mind data may be warehoused in CSO. • Will data be public access and how will it be accessed? • NMCP should be as cooperative as possible to avoid delays. • Sampling frame created for DHS surveys and advice is to use the CSO sampling frame which is known. • Need to create a working dialogue with CSOs in order to get the best out the CSOs. Horizontal dialogue may be most practical. If use of altitude is a big consideration since it will have to be created using two sets. • Domains of interest must be included: rural/urban, malaria endemic zones, pregnant women, U5s • If there is no sampling frame or it is too old. Work with CSO to create one. • Choice of paper or PDA should be done. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

8. MIS Planning Logistics and Procurement • Sample of requirements provided. • Most of MIS logistics need enough lead time for procurement. • Logistical roles and technical roles more efficient than for the same individuals to be doing both. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

9. Budgeting for a MIS • A sample is provided on CD in Excel. NMCPs should try it out. Will need the sample for quantification. • MIS is not cheap and enough resources should be planned. • Do a protocol and then use it for fund raising. Not easy if start from an amount of money and try to fit MIS into the money. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

10. Parasitemia and anemia testing - who should be tested and treatment guidelines • What are the questions you want to answer? • Parasitemia • U5s, up to 9 yrs • Ethiopia did all people in 1 in 4 hhds. In Kenya sample per EA was increased to 36 hhds. • RDTs for treatment, impt are slides • Anaemia • U5s (not older population) • Lower endemic countries: not useful indicator RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

11. Questionnaires: overview and country specificities • Two questionnaires: household and women’s questionnaire. • Questionnaire design should be the task of the MIS Core Team. Qnaires have carefully been developed and additions. • However, country specific adjustments are possible. • Bear in mind that enough lead time is necessary for reprogramming of PDAs. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

12. Working with PDAs and GPS • PDA specifications to be standardized. • PDAs have proven to be a key tool in data collection. • It minimises data collection errors by enumerators and hastens data entry. • However, programming capacity very low. • Also, choice of specifications of PDAs must be shared to get most appropriate PDAs and GPS modules on the market. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

13. Selecting and training data collectors • Because the MIS includes a blood collection section we have found that including trained health workers who usually collect blood in their work is a must. • This is in line with ethical clearance requirements. Also enough time must be allowed between the invitation and the training session. • The selection of the enumerator must take into account of the language of the local communities where the data collection is going to take place. • Duration of training: longer is better than shorter. • Five days for the training and an extra two days of field pre-testing has worked in past. • An extra day must be allowed for debriefing and feedback from the field experience. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

14. Supervising and troubleshooting field work • Supervision is of critical importance. • Should be more trained than the enumerators. • Could be trained before main training. • First and last days of MIS are most critical for supervision. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

15. Analysing data and writing the report • Data cleaning, weighting and analysis from the MIS dataset is not readily available. • Solution is to involve CSO. • Analysis should be weighted and use the sampling frame considerations. Long process and NMCP should know. • Further analysis of MIS is also possible. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

16. Disseminating the MIS results and using the media • Communication = information + presentation • You have done all the hard work and have information. Presentation of the info in various forms must be borne in mind. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

17. Using the MIS results for future planning • Critical review of indicators can be done • Use info for taking action, especially to change future direction. • Important point: Results should be used for policy change and future planning • Meetings should be planned. • Results may have huge implications: high coverage and move towards more monitoring than evaluation. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia