Health officials in Liberia have created a national database for communicable diseases, including malaria, but told IRIN that routine data collection is still hobbled by years of war-time negligence of health, including information management.
“Data is a huge problem,” said the deputy director of the country’s National Malaria Control Programme, Tolbert Nyenswah. “It is one thing to conduct periodic surveys, but another thing to get treatment reports from the various health centres, to measure disease prevalence and the number of houses with mosquito nets.”
Malaria was the leading cause of death for hospitalised patients in 2005, according to the government, which estimated fever cases suspected to be malaria in 2006 ranged from 1.1 million to 4.3 million.
Nyenswah said health workers are finalising a study to update five-year old malaria data, expected to be published by July. But this National Malaria Indicator Study, which health officials expect to carry out every two years, is not sufficient, he told IRIN. “Between survey years, we would still not have updated information on disease burden. How can we accurately treat what we do not know?”
|How can we accurately treat what we do not know?|
The recently designed database is intended to fill that gap, providing updated information about the country’s biggest killers, including HIV, tuberculosis and malaria. “We are revitalising our information system now, which was destroyed by the war.” He said the last time data was gathered, it had been less than two years since fighting officially ended and not all of the country was accessible.
Some 95 percent of the country’s health facilities were destroyed in the war, according to the US Agency for International Development (USAID).
To roll out the new database, Nyenswah said the government needs to buy and configure computers, purchase software, print forms, hire and train data collectors to update the database and recruit consultants to analyse the data. “Training has begun, but this will be slow. This is a new culture for us and we do not have the necessary support yet.” None of the staff members of the national malaria control team have research experience or public health training.
A part of the approved US$12.7-million grant from The Global Fund to Fight AIDS, Tuberculosis and Malaria last year, the first part of a five-year grant expected to reach $37 million, will cover the country’s top malaria officers travel to pursue public health degrees outside of Liberia, as well as unspecified incentives “to avoid brain drain", as written in the 2007 funding proposal.
With 2008 World Bank support the government bought 30 motorbikes to survey remote areas. “Our roads are in such disrepair that it is extremely difficult to access some places during the rainy season. We could not get there in a four-by-four,” said the health officer.
In many ways, Nyenswah said, the road to accurate data will be long.