Malaria surveillance and use of evidence in planning and decision making in Kilosa District, Tanzania

Background: Since 2001, Tanzania has been making concerted efforts to strengthen its Integrated Disease Surveillance and Response system. In this system, malaria is one of the priority diseases that are to be reported monthly. The objectives of this study were to (i) assess malaria surveillance system at facility and district levels to identify key barriers, constraints and priority actions for malaria surveillance strengthening; and (ii) to explore the use of evidence in health planning and decision making at these levels. Methods: The study was carried in Kilosa District in central Tanzania, during October 2012 and involved health facility workers and members of the district health management team. The existing information system on malaria was evaluated using a structured questionnaire and check list. Data collection also involved direct observations of reporting and processing, assessment of report forms and reports of processed data. Results: Three district officials and 17 health facility workers from both public and private health facilities were interviewed. Of the 17 informants, 15 were familiar with disease surveillance functions. A good percentage (47%, 8/17) received training on disease surveillance during the previous two years. Public transport and motorcycles were the main means of reporting epidemiological information from facility to district level. Most of the health facilities (93%, 14/15) faced difficulties in submitting reports due to lack of resources and feedback from the district authority. Analysis of malaria data was reported in 52.9% (9/17) of the facilities, but limited to malaria incidence per age groups. Challenges in data analysis included unavailability of compilation books; lack of computers; poor data storage; incomplete recording; lack of adequate skills for data analysis; and increase in workloads. Data at both facility and district levels were mainly used for quantification and forecasting of drug requirements. Conclusion: Malaria surveillance system in Kilosa district is weak and utilization of evidence for planning and decision making is poor. Capacity strengthening on data analysis and utilization should be given a priority at both facility and district levels of the health systems in Tanzania.