Sentinel Vital Registration & Verbal Autopsy Help Put Malaria on the Map in Tanzania

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  • Sentinel Vital Registration & Verbal Autopsy Help Put Malaria on the Map in Tanzania

    1. 1. Business as unusual Tanzania Sentinel Vital Registration & Verbal Autopsy Help Put Malaria on the Map in Tanzania
    2. 2. Participants <ul><li>Adult Morbidity and Mortality Project (AMMP), Tanzania Ministry of Health/UK DFID </li></ul><ul><ul><li>Generated cause-specific mortality information 1993 – 2004 </li></ul></ul><ul><ul><li>Facilitated mortality information use 1998 – 2004 </li></ul></ul><ul><li>MEASURE Evaluation collaborated in the facilitation of information use 2003 – 2004 </li></ul>Symposium 2008 www.cpc.unc.edu/measure
    3. 3. Program decisions <ul><li>Content of National Package of Essential Health Interventions , including first-line treatment of malaria </li></ul><ul><li>Design of Comprehensive Council Health Plans to guide block grants to Local Government Authorities </li></ul>Symposium 2008 www.cpc.unc.edu/measure
    4. 4. Business as “usual” <ul><li>Top-down priority setting, donor-driven targets </li></ul><ul><li>Model-based estimates rather than empirical data </li></ul><ul><li>Lack of routine vital event registration or cause of death data, especially at local level </li></ul><ul><li>Local authorities only had access to facility-based data on malaria cases treated </li></ul><ul><ul><li>Nothing from the community! </li></ul></ul>Symposium 2008 www.cpc.unc.edu/measure
    5. 5. Business Un usual: The “DDIU way” <ul><li>Strengthened local routine data collection – vital event registration and verbal autopsy </li></ul><ul><li>Wider participation of national and local stakeholders and decision-makers </li></ul><ul><li>Production of action-oriented information products </li></ul><ul><li>Now Districts aware of community malaria mortality burden : </li></ul><ul><ul><li>Those who never reached care and died at home </li></ul></ul><ul><ul><li>Those who were treated – and died anyway </li></ul></ul>Symposium 2008 www.cpc.unc.edu/measure
    6. 6. Fostering collaboration <ul><li>Strengthening Health Management workshops to train Council Health Management Teams in using vital registration data for district planning </li></ul><ul><li>Collaboration with district teams and Ministry of Health to produce and distribute information products </li></ul>Symposium 2008 www.cpc.unc.edu/measure
    7. 7. New Information Products <ul><li>Annual district mortality profiles </li></ul><ul><ul><li>Data presented according to ‘intervention-addressable’ mortality to facilitate decision-making </li></ul></ul><ul><li>Annual ‘indicator packages’ for malaria control and beyond </li></ul><ul><li>CD-ROM and web based tools to increase access to mortality information </li></ul>Symposium 2008 www.cpc.unc.edu/measure
    8. 8. Information Use <ul><li>MOH changed first-line malaria treatment from chloroquine to fansidar </li></ul><ul><li>Increased district budget allocations for malaria </li></ul><ul><li>District promotion of social marketing of insecticide-treated bed nets for malaria prevention </li></ul><ul><li>National voucher system based on district experience </li></ul>Symposium 2008 www.cpc.unc.edu/measure
    9. 9. What was significant? <ul><li>New and increased awareness of importance of malaria and shortcomings in response to the disease </li></ul><ul><li>Ongoing district mortality surveillance </li></ul><ul><li>Regular dissemination of vital registration information to the Ministry of Health, National Malaria Control Program and other stakeholders </li></ul><ul><li>Strengthened monitoring and evaluation of drug and treatment policies and priority programs </li></ul>Symposium 2008 www.cpc.unc.edu/measure

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