Contribution of private health facilities to malaria surveillance in southern, Copperbelt and Lusaka provinces, of Zambia.
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Date
2019
Authors
Gama, Angela
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Malaria is one of the leading causes of death in the world with Sub-Saharan Africa carrying 92 percent of malaria deaths. Malaria remains a serious public health problem in Zambia causing 12 percent of the reported deaths annually. Zambia has moved from accelerated malaria burden reduction to malaria elimination which requires the national malaria surveillance system to capture all the cases both from the public and private sector to ensure a complete and accurate picture of malaria incidence. However there is a gap in knowledge on the proportion of malaria cases in the Health Management Information System (HMIS) that are from private health facilities and factors that are associated with private facilities reporting malaria in HMIS.This study aimed to determine factors associated with private facilities reporting malaria in HMIS and the proportion of malaria cases in HMIS that were from private health facilities in Southern, Copperbelt and Lusaka Provinces, of Zambia. This study was a cross sectional study design. HMIS data were used to examine the proportion
of the malaria cases that were from the Private facilities in the year 2012 to 2017. A structured questionnaire was used to collect information from the heads of private health facilities (or individuals nominated by the heads of the facilities) on factors associated with private facilities participating in malaria surveillance in Southern, Copperbelt and Lusaka province. In the year 2017, 36% (n=36/99) of the private health facilities in the Copperbelt, 15% (n=4/27) in Lusaka and 8% (n=1/13) in Southern province reported malaria in HMIS. Private health facilities in the Copperbelt, Lusaka and Southern province contributed 8 percent of all the
malaria cases that were reported in the HMIS from 2012-2017. In multivariable logistic regression analysis, after adjusting for the confounding effects of the number of record clerks and doctors the private health facility had and having electricity back up, private facilities that had been operating for more than 20 years had three times increased odds of reporting malaria in HMIS (AOR=3.22, 95% CI: 1.23, 8.42; P-value 0.02) compared to those that had been
operating for less than 20 years. Private facilities that were located in the Copperbelt province (AOR=2.20 95% CI: 1.35, 3.58; P-value <0.01) had two times greater odds of reporting malaria in HMIS compared to those that were located in Lusaka province. The private facilities that had staff who were aware about malaria surveillance had two times greater odds of reporting malaria in HMIS (AOR=2.06 95% CI: 1.38, 3.99; P-value <0.01) compared to those that were
not aware. The study has shown that the private sector clearly is seeing malaria cases and these need to be reported and part of the overall national surveillance system. The main factors associated with private health facilities reporting malaria in HMIS included, the private health facility operating
more than 20 years, the staff being aware and trained in malaria surveillance and the private health facility having more than five nurses. Trainings of private providers on malaria surveillance is recommended to improve reporting in HMIS
Description
Thesis of Master of Science in Epidemiology