Mozambique, in south-eastern Africa, bears the brunt of its malaria; it’s still a major source of morbidity and mortality. Progress over recent years, however, has been remarkable, especially for the country’s malaria surveillance system. There are some lessons that Mozambique can teach the world about malaria control. Here are three success stories.
Understanding the Malaria Challenge in Mozambique
The country of Mozambique is considered malarious since it has a high incidence of malaria. This is due to the favorable conditions that favor the occurrence of malaria, poor access to health care, and lack of community education. The burden of malaria is the greatest deterrent to both economic development and life quality in the country of Mozambique.
Before the adjustment, malaria-control efforts in Mozambique suffered from under-collection and under-reporting. This newly robust surveillance system has played a major role in turning things around.
The Importance of Surveillance in Malaria Control
Surveillance is essential to combatting malaria: it is the systematic collection, analysis, and use of data about where and when the disease is malarious. Regular assessments of the distribution of malaria can inform strategic decisions about where and when to intervene most effectively. They enable the rapid detection of and response to outbreaks, more productive use of resources, and an improved chance of reaching the goal of near-elimination of malaria on the African continent by 2030.
In Mozambique, improving our malaria surveillance systems has provided better data, better-informed decision-making, and a better response to the disease by further exploring the links that we’d mapped. In Mozambique, for example, there are various interventions and systems underway in several sites that involve different partners and harness different shades of grey. As one story follows another, it is beginning to read like a series of successes.
Success Story 1: The Implementation of Digital Surveillance Tools
Background
Before the digital revolution, data for malaria surveillance came from paper-based processes in Mozambique. They were slow, error-prone, and difficult to process. With the support of international partners, Mozambique’s health authorities wanted to digitize the surveillance.
Approach
It called for the introduction of electronic health records (EHR) and mobile reporting applications to health facilities throughout the country equipped with tablets and smartphones to record and transmit data from these facilities. This allowed for increased data accuracy and timeliness.
Outcomes
The digital tools have revolutionized malaria surveillance in Mozambique. Key outcomes include:
- Data collected in real-time: health workers report cases of malaria as they happen, which enables further action and monitoring.
- More reliable data: Human-borne errors in data entry have fallen since the advent of digital systems. A focus on data means better data.
- Better Decision-Making: With instant data, decision-making about allocations and interventions has been faster.
Success Story 2: Community-Based Surveillance Initiatives
Background
In a rural setting, like some places in Mozambique, people might live far from a health facility, and, given that most patients seek care at health facilities, proper surveillance and response are hampered. Community-based surveillance seems a way out.
Approach
Community health workers (CHWs) are also crucial in these projects, trained to identify and report cases of malaria to their community. They use mobile phones to relay data to central health authorities, extending the reach of health facilities far from remote areas.
Outcomes
The community-based surveillance approach has yielded impressive results:
- Enhanced case detection: local people are now screening for malaria, identifying cases sooner for quick treatment and minimizing transmission.
- Empowering Local Communities: CHWs are central to the success of the program; they both collect malaria surveillance data, as well as do health education and prevention activities.
- Stronger Health Systems: Community-based data feed directly into national surveillance systems.
Success Story 3: Collaborative Efforts with International Partners
Background
The fight against malaria requires different stakeholders such as international organizations, non-governmental organizations (NGOs), and also local governments to put their acts together. Partnerships between different entities powerfully boosted the malaria surveillance system, as is the case of Mozambique.
Approach
Mozambique has coordinated efforts with the WHO, the Global Fund, and a variety of NGOs to shore up surveillance systems with technical assistance, funding, and know-how.
Outcomes
The collaborative approach has led to several notable achievements:
- Capacity Building: We’ve had international partners coming to help build the skill capacity of the health workers. To help strengthen the surveillance infrastructure.
- Resource Mobilisation: Over the years, donor funds from various international organizations have helped with the procurement of equipment and technology necessary for efficient surveillance.
- Global collaborations: working with international experts has helped to share best practices and innovative approaches to malaria surveillance.
Lessons Learned from Mozambique’s Success Stories
The success of Mozambique holds lessons for the rest of the world in its fight against malaria. Here are four things we can learn from them.
Invest in technology The shift from paper-based systems to digital tools has been very successful. Investing in technology for data collection and reporting can significantly improve malaria surveillance through increased accuracy and timeliness.
- Community-based Engagement: Empowering and engaging community health workers together with other residents can strengthen surveillance efforts for faster, earlier, and more extensive identification of malaria cases.
- Foster Partnerships: While it is up to nations to develop and sustain surveillance systems, international organizations, and NGOs have the resources, personnel, and contacts that can be useful for that country to build capacity, catch up with the latest innovations, and pool knowledge and best practices.
- Invest in training and capacity building: Finally, but most importantly, make sure that health workers are trained well to do surveillance tasks and that ongoing investment in training capacity is a priority.
- Use Surveillance Data to Inform Decisions: Near real-time data allow for more decision-informed, targeted interventions. Use the surveillance data to guide response strategies and target resources.
Mozambique’s journey towards improving its malaria surveillance system has been a series of stories – some of triumph, others of learning, but all that allude to the potential for developing robust strategies to fight the disease by leveraging the benefits of new sources of digital technology, including citizen involvement and international collaborations. These stories not only highlight that certain strategies work, but they also offer a roadmap for other countries. Credits: Kathryn Allan and Baizaras Mahedeva
Mozambique’s experience illustrates how the prospect of elimination can shape the course of local malaria control, and how the prospect of re-emergence can guide how to maintain gains. If and when Mozambique eliminates malaria, its experience will stand as a source of inspiration – and a guide – to malaria control programs around the world.
That nation’s victory over malaria is inspiring and serves as a reminder that the fight can be won with innovation, collaboration, and a well-directed, consistent effort to save lives through public health.
