The DHIS2 Effect: Adherence to Malaria Treatment Standards/Guidelines in Karenga District, Uganda

Through the Ministry of Health, the Ugandan government developed a Quality Improvement Framework and Strategic Plan for the health sector for the fiscal years 2020/21-2024/25 in order to ensure the provision of quality services in a variety of programmatic areas, including reproductive, maternal, new-born, and child health (RMNCH), tuberculosis (TB), HIV, laboratory, and diagnostic services. Using the principles indicated therein, a significant issue was observed in the management of malaria. It was observed that 22% of the malaria cases that were treated during the fiscal year 2019/20 were not laboratory confirmed. Consequently, this was in violation of the standards established by the Ministry of Health, which stipulate that clients should only be treated when the laboratory has confirmed the presence of the illness. With the numbers significantly higher than the acceptable level of less than or equal to 5%, the district health team, which was led by the District Malaria Focal Person and supported by the Quality Improvement (QI) Focal Person, held meetings with the staff of health facilities across the district. These meetings included the in-charges, clinicians, medicine/dispensers, nurses, and laboratory technicians, among other individuals. And were geared toward identifying the causes of the problem at hand. During the interactive sessions, it was discovered that some of the contributing factors included poor documentation, laxity on the part of some healthcare staff, a lack of proper client flow between the screening section and the dispensing section within the facility, and non-adherence to the existing guidelines through clinical diagnosis, as well as stock-outs of testing kits. One of the most important results was that the various facilities collaborated on a brainstorming session and came up with tested adjustments that were subsequently adopted for execution. The following are some of the improvements that were tested: ensuring that the appropriate documentation is completed in the HMIS registers; ensuring that the staff work methods are monitored appropriately; ensuring that the client flow is organized and proper; and providing facility staff with refresher training and/or orientation. An examination of the data from generated through the District Health Information System (DHIS2) for the most recent fiscal year, FY2022/23, revealed that one hundred percent of the clients who were treated for malaria were confirmed at the laboratory. This demonstrates the efficacy of making decisions based on data, which is made possible by the various capabilities contained inside the DHIS2 system.

Authors:

  1. Mallo Paul Lokiru
    Company/Organization : Karenga District Local Government, Uganda
    Current Position : Biostatistician
    Email : plmallo1991@outlook.com

  2. Margaret Akello
    Company/Organization : Karenga District Local Government
    Current Position : Assistant Vector Control Officer/Malaria Focal Person
    Email : margieak9@gmail.com