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Fighting epidemics with data mapping: How DHIS2 is driving disease eradication in Madagascar

DHIS2 training sessions being held in Madagascar.Developments in the software are being used to target epidemic issues in the area

The challenge ahead 

Yersinia pestis.  Two words, and according to the World Health Organization (WHO), the pseudonym for 1801 confirmed cases of the plague in Madagascar since a huge outbreak that started in August 2017.   

 

Madagascar’s Ministry of Health has long been combatting these seasonal epidemics that see their peak between September and April, and have already identified several types, including bubonic, septicaemic, and pneumonic cases in 51 of 114 of its districts.  Such information may seem to pose a daunting problem in the face of the disease’s consequences, but the government is well up to the task.

Side by side: to the left, geographic distribution of bubonic plague cases; to the right, distribution of pneumonic plague cases (WHO, Plague- Madagascar)

In October 2017, PSI Madagascar and the Ministry Health began collaborating

in partnership to configure DHIS2, PSI’s management information system, in order to capture case instances and outbreak data with its unique visual data displays and geographic information mapping tools. 35 ministry branches have already been trained on the software’s use, and thanks to the ability to easily upload and see various data elements to DHIS2, dis-aggregated information on outbreak instances can be tracked, recorded, and analyzed. Essentially, implementation of DHIS2 helps collect information on-the-go, meeting different projects’ needs and can be easily integrated with other interfaces. These are all elements vital to confronting the plague challenge at hand back in Madagascar. 

(First down)
A table from the DHIS2 dashboard “PESTE- Number of callers per day (Madagascar)”
(second)
A geographic map from the DHIS2 dashboard, “Number of satisfied callers- this month” and “Other reasons for calling- this month”

PSI Madagascar knew

it needed a quick efficient way to track outbreaks. For this they turned to a fellow network member. In 2016, PSI/Madagascar began considering DHIS2, since they knew they needed a system that would show supervision routes and target low-performing providers with high client volume. The need for a tool that would ultimately give the program and the ministry of health the ability to see disease outbreaks and clinics in concentrated zones required the capabilities of DHIS2.  As the charts show above, DHIS2 is being used to track and record data on the number and location of phone calls of individuals wanting treatments or information on disease.  Now, public and private health networks can review the visuals and make informed decisions on future action plans that will address geographic and demographic ranges of high plague concentration.  

 

Currently in Madagascar, according to the WHO, 83% of individuals identified with the plague have received follow-up monitoring, and 95% of those in contact with the plague were provided with antibiotics by field teams (WHO, Plague-Madagascar). GBS and PSI global continue to work alongside the ministry of health to push better healthcare for Sara and Sam, and envision even greater collaboration with government and public networks to ensure better and more effective healthcare for them. 

 

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