Malaria Surveillance system evaluation in Ankober woreda North Shewa, Amhara region, Ethiopia, 2022

Abstract Background: Malaria remains one of the most important causes of human morbidity and mortality with enormous medical, economic and emotional impact in the world. The World malaria report 2018 estimates that there were 219 million cases of malaria in 2017 globally. The WHO African Region accounted for most global cases of malaria (200 million or 92%), followed by the WHO South-East Asia Region with 5% of the cases. Routine malaria surveillance data is useful for assessing incidence and trends over time and helps to detect cases early and manage them promptly. The purpose of evaluating malaria surveillance systems is to ensure that problems of malaria surveillance are being monitored efficiently and effectively. It focuses on how well the system operates to meet its purpose and objectives. So this study is used to measure the performance of the existing Malaria surveillance system in guiding decision makers to take actions effectively and timely. General objective: Descriptive study to evaluate the performance of the existing Malaria surveillance system and to assess the status of surveillance system attributes of malaria in Ankober woreda, North Shewa, Amhara from December 16-26 2022. Method: A descriptive cross sectional study were conducted from December 16-26, 2022. Ankober woreda were selected randomly among 239 malaria elimination targeted districts and total of nine health facilities (three health center and six health posts) were selected. The data were collected from surveillance officers in the selected health facilities using CDC surveillance system evaluation guideline check-list. Collected data then were transferred in to electronic version and descriptive analysis were performed using Microsoft excel 2013. Result: Case definitions found posted in all health centers and understanding of it were good. The woreda did received and report a total of 26 confirmed malaria cases among 195 clinically suspected cases and zero deaths in 2011 EFY. The overall completeness and timeliness of the woreda for 2022 were 100% and 97% respectively. Malaria epidemic monitoring chart were used to detect changes in cases but not analyzed by place and person. Irregular feedback and supportive supervision was assessed and confirmed by the study. High staff turnover and less trained and poorly incentivized health personals with poor motivation and satisfaction with their job found. The surveillance system were found to be useful, simple, flexible, acceptable, sensitive, and representative to all surveillance officers but not stable. Conclusion: Most surveillance system attributes are good but the stability of the system is misfortune. Working surveillance as an additional job and reduced training opportunity added with poor incentive mechanism may make low motivation and satisfaction with their job that definitely affect the stability of the system. The Malaria surveillance system presented in all assessed health institutions of Ankober woreda was found to be able to determine the magnitude of the disease for planning and intervention and detect change in malaria mortality and morbidity And it also found to be satisfactory to achieve the intended objective of surveillance for public health action.