Data-driven actions: Responding to a malaria upsurge

 {Photo credit: UHSC/MSH staff}A pharmacist dispenses medicines to a patient at Arua Regional Referral Hospital.Photo credit: UHSC/MSH staff

Uganda experienced a large number of malaria cases in April and May 2019. While this would normally correlate with patterns of seasonality, the season’s peak extended past May, with the highest number of observed cases recorded in July 2019. Trend data from 81 of Uganda’s 134 districts suggest that the districts experienced unprecedented upsurges of registered malaria cases well past the normal timeframe.

The USAID-funded Uganda Health Supply Chain Project (UHSC) supported the National Malaria Control Division in analyzing data and generating a dashboard of monthly stock status reports. The dashboard is populated by pulling data from the District Health Information System 2 (DHIS2), to which more than 4,000 public and private health facilities submit monthly commodity stock reports.

At the central level, using the July–August 2019 stock report data, UHSC reviewed district procurement plans and kits for all lower-level health facilities in the 81 most affected districts. This review found that the kits developed by the districts the previous year did not provide sufficient commodities to maintain stock within the recommended levels—a challenge that was compounded by the prolonged upsurge in cases.

Dr. George Didi Bhoka, the district health officer of Adjumani district, said, “Through our routine epidemiological surveillance as a district health team, we proactively identified the upsurge and reached out to [the] Ministry of Health requesting supplementary supplies, the Ministry of Health and National Medical Stores worked promptly using the district data in DHIS2 and availed additional stocks of ACTs, malaria diagnostic kits and IV Artesunate, this stock received in Cycle 2 [August–September] provided sufficient stocks to support our response to the upsurge through proper and timely case management.”

UHSC worked with the National Medical Stores, the district health teams, and regional implementing partners to guide the revision of district delivery and procurement of kits for the 81 districts most affected by the upsurge and whose stock levels had fallen below the minimum level of two months’ worth of stock available. The revision ensured that bimonthly stock refills brought a district’s stock up to the maximum level to manage the malaria upsurge.

UHSC used available logistics data to support the districts, National Medical Stores, and implementing partners to conduct timely and coordinated responses to prevent stock-outs of lifesaving commodities and efficiently respond to emergency situations, averting death and disease progression.