Surveillance Monitoring, Evaluation and Operational Research (SMEOR)
The National Malaria Control Programme has the responsibility to monitor the Kenya Malaria Strategy's success toward its stated targets, work in collaboration with national partners to identify ways to measure its intended goal achievement and actively solicit and advocate research to refine strategic approaches. The SMEOR activities are guided by the Monitoring &Evaluation and the Operational Research Technical Working Groups which comprise various partners. These two groups were actively involved in the revision of the National Malaria Strategy 2009-2017 and monitoring and Evaluation plan and have helped in the development in the revised Kenya Malaria Strategy 2014-2018 and the Monitoring and Evaluation plan 2014-2018
According to the Malaria Policy
The Government of Kenya shall ensure that:
• The M&E of malaria activities in Kenya is guided by a comprehensive national Malaria M&E Plan
• M&E becomes an integral and relevant part of malaria Control and adequate resources are committed to its implementation
• There is efficient monitoring and evaluation of the strategic approaches to malaria prevention control
• Joint annual performance reviews of operation plans are conducted
• Targeted operational research that informs malaria control policy and strategy are promoted and supported
• Collaborating research partners are engaged to translate research output into policy
• Effective channels of communication and dissemination of research findings are promoted
The monitoring and evaluation plan contains all the indicators, their source and frequency for their measurement to fulfil the monitoring and evaluation of the malaria control activities in Kenya and thus guide implementing partners what ought to be measured. These indicators are harmonized with guidance from the World Health Organization documents.
In the recent past the Malaria Control Programme has produced several M&E products like the Annual Malaria Reports and the quarterly malaria surveillance bulletins which is circulated quarterly to malaria partners. These products are available for downloading in the resource centre.
To assess the overall impact of the National Malaria Strategy on the health of the community at large the malaria programmes uses two surveys to inform itself:
1) the Kenya Malaria Indicator Survey: These surveys are to be conducted every 3 years. The NMCP has conducted two Kenya Malaria Indicator Surveys (KMIS); the first was conducted in 2007 and then followed by KMIS 2010. These surveys have been used to inform strategic direction. The programme is preparing itself for the KMIS 2015 which will inform of progress from 2010 and well as coverage of malaria interventions. The KMIS is conducted every three years, it was supposed have been conducted n 2013 but since the KDHS was planned during that same period the KMIS was postponed to 2014 and then to 2015 because of the KDHS.
2) Kenya Demographic Health Survey: This is conducted every 5 years in collaboration with the health sector and informs the program on child mortality indicator of 20% is attributed to malaria. The NMCP is usually involved in the KDHS planning, fieldwork and also report writing.
To monitor our malaria out -patient quality of care in public facilities health facility surveys are conducted every 6 months since 2010. It monitors availability of malaria case management commodities and health worker adherence to the national guidelines. The latest report is available on the this website.
The NMCP in concert with the Health Management Informatics Unit has revised the registers used in the health facilities so that variables that satisfy the malaria indicators are captured. Currently the malaria programme uses the District Health Information Software (DHIS) to get its routine information from the outpatient, antenatal Care clinics and the Child welfare clinics. Information on logistics management for the case management commodities (RDTs and ACTs and SPs) are tracked through the Malaria Commodity form that is housed in the DHIS. This assists in the quantification and forecasting of our commodity needs.
For malaria surveillance activities routine information is accessed through the electronic Integrated Disease Surveillance system (e-IDSR). This information assists the epidemic prone areas and seasonal transmission areas in the detection of evolving malaria epidemics. Trainings have been conducted on malaria surveillance including entomological surveillance for health workers in seasonal transmission areas. This is so that they can detect epidemics since in the past it was only the epidemic prone areas that received this capacity building.
Data from the two routine systems is used to produce the quarterly surveillance bulletin which comprises the WHO surveillance graphs and some tables broken down by County. This bulletins are circulated every quarter to the Counties and other partners.
The NMCP has conducted a two malaria fora (in 2012 and 2014 respectively) that brought together policy makers and researchers so that latest information in the malaria field could be shared. The reports of the forums are available in the resource centre. The evidence presented at the forum will be used to revise the Malaria Operational research agenda. The OR TWG will meet annually to revise the research agenda and to discuss progress on the research questions. It will hope to resource mobilize for 3 research questions per year form nay intervention area.
Malaria M&E needs assessment
The NMCP underwent the above activity in 2013 which identified needs of the programme. The same was administered to the Counties and an M&E capacity building plan was formulated from the above results.
The Malaria Information Acquisition System (MIAS)
The M&E unit, with support from USAID, is setting up a Malaria Information Acquisition System (MIAS) that will collate malaria information from HMIS, IDSR, surveys, operational research papers and other sources so that analysis of processes and interventions can be done. It will also have a financial component that will help in the tracking of finances. The MIAS will also help in generation of reports of various activities that the NMCP has undertaken with its partners.