Effectiveness of Implementation of Electronic Malaria Information System as the National Malaria Surveillance System in Thailand

Abstract

BackgroundIn moving toward malaria elimination, one strategy is to implement an active surveillance system for effective case management. Thailand has developed and implemented the electronic Malaria Information System (eMIS) capturing individualized electronic records of suspected or confirmed malaria cases.ObjectiveThe main purpose of this study was to determine how well the eMIS improves the quality of Thailand’s malaria surveillance system. In particular, the focus of the study was to evaluate the effectiveness of the eMIS in terms of the system users’ perception and the system outcomes (ie, quality of data) regarding the management of malaria patients.MethodsA mixed-methods technique was used with the framework based on system effectiveness attributes: data quality, timeliness, simplicity, acceptability, flexibility, stability, and usefulness. Three methods were utilized: data records review, survey of system users, and in-depth interviews with key stakeholders. From the two highest endemic provinces, paper forms matching electronic records of 4455 noninfected and 784 malaria-infected cases were reviewed. Web-based anonymous questionnaires were distributed to all 129 eMIS data entry staff throughout Thailand, and semistructured interviews were conducted with 12 management-level officers.ResultsThe eMIS is well accepted by system users at both management and operational levels. The data quality has enabled malaria personnel to perform more effective prevention and control activities. There is evidence of practices resulting in inconsistencies and logical errors in data reporting. Critical data elements were mostly completed, except for a few related to certain dates and area classifications. Timeliness in reporting a case to the system was acceptable with a delay of 3-4 days. The evaluation of quantitative and qualitative data confirmed that the eMIS has high levels of simplicity, acceptability, stability, and flexibility.ConclusionsOverall, the system implemented has achieved its objective. The results of the study suggested that the eMIS helps improve the quality of Thailand’s malaria surveillance system. As the national malaria surveillance system, the eMIS’s functionalities have provided the malaria staff working at the point of care with close-to-real-time case management data quality, covering case detection, case investigation, drug compliance, and follow-up visits. Such features has led to an improvement in the quality of the malaria control program; the government officials now have quicker access to both individual and aggregated data to promptly react to possible outbreak. The eMIS thus plays one of the key roles in moving toward the national goal of malaria elimination by the next decade.

Challenges in early phase of implementing the 1-3-7 surveillance and response approach in malaria elimination setting: A field study from Myanmar

“…Unifying and streamlining case reporting is necessary to maintain the database at the central malaria server error-and duplication-free. The introduction of the electronic Malaria Information System (eMIS) in Thailand improved point-of-care and real-time data quality and case management [26,27]. Similarly, replacing paper-based reporting system with a mobile reporting system in South Africa substantially shortened the time period between case detection and reporting: the frontline health works readily adopted the system primarily due to the simplicity of its use [28].…”

Evaluation of the malaria reporting system supported by the District Health Information System 2 in Solomon Islands

“…In two districts of Zambia a successful pilot has been reported, whereby mobile phones applications are used to submit reports including cases, and medical and diagnostics supplies to a DHIS2 database, and from which feed-back is received by field officers [54]. Other studies have shown electronic reporting can be effective tools for submitting reports in near real-time [55][56][57]. Unlike other programs such as for tuberculosis, acute respiratory infections and immunization that involve aggregated reporting, the malaria program in Solomon Islands uses case-based reporting.…”

Evaluation of the District Health Information System 2 supported malaria reporting system in Solomon Islands

“…In two districts of Zambia a successful piloted has been reported, whereby mobile phones applications are used to submit reports including cases, and medical and diagnostics supplies to a DHIS2 database, and from which feed-back is received by eld o cers [55]. Other studies have shown electronic reporting can be effective tools for submitting reports in near real-time [56][57][58]. Unlike other programs such as for tuberculosis, acute respiratory infections and immunization that involve aggregated reporting, the malaria program in Solomon Islands uses case-based reporting.…”