Surveillance Monitoring, Evaluation and Operational Research (SMEOR)
The National Malaria Control Programme has the responsibility of monitoring the Kenya Malaria Strategic Plan's success towards its stated targets. The NMCP works in collaboration with national partners to identify ways to measure its intended goal achievement and actively solicit and advocate for research to refine its strategic approaches.
The SMEOR activities are guided by the Monitoring & Evaluation and the Operational Research technical working Groups which comprise of various partners. These 2 groups were actively involved in the revision of the National Malaria Strategy for 2009-2017 and the monitoring and evaluation plan. They have also helped in the development in the revised Kenya Malaria Strategic Plan for 2014-2018 and the Monitoring and Evaluation Plan for 2014-2018.
According to the malaria policy, the Government of Kenya shall ensure that:
Monitoring and evaluation of malaria activities in Kenya is guided by a comprehensive National Malaria Monitoring and Evaluation Plan.
Monitoring and evaluation becomes an integral and relevant part of malaria control and that 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 policies and strategies 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 sources and frequency of their measurement to fulfill the monitoring and evaluation of malaria control activities in Kenya. This guides the implementing partners on aspects to be measured. These indicators are harmonised in tandem with documents from the World Health Organisation.
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 are 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 NCMP uses two surveys to inform itself.
1. The Kenya Malaria Indicator Survey (KMIS)
This survey is supposed to be conducted after every 3 years. The NMCP has so far conducted two surveys. The first one was conducted in 2007 and was followed by another one in 2010. These surveys have been used to inform strategic direction. The NCMP is preparing itself for the KMIS 2015 which will inform on the progress of malaria control in Kenya since 2010 as well as the coverage of malaria interventions. A KMIS was supposed to have been conducted in 2013.However,since the Kenya Demographic and Health Survey (KDHS) was planned during the same period, it was postponed to 2014 and subsequently to 2015.This was due to the delays experienced in conducting the KDHS.
2. Kenya Demographic Health Survey (KDHS)
This is conducted after every 5 years. It is done in collaboration with the health sector. The survey informed the NCMP that 20% of child deaths in Kenya are attributed to malaria. The NMCP is usually involved in the KDHS planning, fieldwork and report writing.
To monitor our malaria out-patient quality of care in public health facilities, health facility surveys have been conducted after every 6 months since 2010. The survey monitors the availability of malaria case management commodities and health workers’ adherence to the national guidelines. The latest health facilities survey report is available on this website.
The NMCP in collaboration with the Health Management Informatics Unit (HMIU) 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 out-patient, antenatal Care clinics and the Child welfare clinics.
Information on logistics management for the case management commodities – Malaria Rapid Diagnostics Tests (RDTs), Artemisinin-based Combination Therapies (ACTs) and Sulfadoxine-Pyrimethamine (SPs) are tracked through the Malaria Commodities 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 and Response (e-IDSR) system. This information assists the epidemic prone areas and seasonal transmission areas in the detection of evolving malaria epidemics.
Currently, the seasonal transmission areas are being capacity built on malaria surveillance including entomological surveillance. This is being done to enable easy and early detection of epidemics. 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 counties. This is sent to the counties and to other partners every quarter.
The NMCP has conducted two malaria forums (in 2012 and 2014 respectively) that brought together policy makers and researchers to share the latest information regarding malaria. The reports from the forums are available in the resource centre. The evidence presented at the forums will be used to revise the Malaria Operational Research Agenda. The Operational Research Technical Working Group (ORTWG) will meet annually to revise the research agenda and to discuss progress on the research questions. It will hope to mobilise resources for 3 research questions per year from any intervention area.
Malaria monitoring and evaluation needs assessment
The NMCP conducted a Malaria M&E needs assessment in 2013 to identify the needs of the programme. The same was administered to the counties and an M&E capacity building plan was formulated from the results.
The Malaria Information Acquisition System (MIAS)
The M&E unit, with support from USAID is revamping the Malaria Information Acquisition System (MIAS) that will collate malaria information from the Health Management Information Systems (HMIS) and Integrated Disease Surveillance and Response (IDSR) surveys, operational research papers and other sources. This will be done so that the 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 the generation of reports of various activities that the NMCP has undertaken with its partners.