In recent years, Laos has made significant progress towards elimination goals with an 80% decrease in cases between 2014 and 2017. Laos plans to eliminate malaria by 2030, and with that goal, a strong surveillance system will be required. In 2016 the Center for Malariology, Parasitology and Entomology (CMPE) worked with the WHO and partners to launch a DHIS2-based system across the country and to make the malaria surveillance components more suited for elimination.
The system rollout began with a rapid assessment of HR and computer capacity at district level while CMPE worked with HISP Vietnam and the Ministry of Health to design data template in DHIS2. A surveillance working group was setup to develop user guidelines and job aids, CMPE systematically contacted province or district staff with data submission issues, and master users provided supervision and refresher training where necessary. Dashboards were developed to provide an overview of key performance indicators, and operational data relevant to malaria elimination.
In 12 months, trainings were conducted in all 18 provinces, to 469 provincial and district staff. Through the phased approach to training and supervision, currently over 1,300 points of service actively report into DHIS2. User activity and data quality in the DHIS2-based system has consistently increased over the past year of implementation, reaching over 90% completeness rates by each province.
Limitations of previous surveillance systems in Laos created a bottleneck for elimination. With the rollout of the DHIS2-based system, malaria surveillance has been strengthened by ensuring timely and accurate reporting of malaria data and increased the utilization of analytics to inform response. Improvements in the system continued in 2018 with the incorporation of private sector, intervention coverage (bednets), and stock management data into the system showcasing Laos as a frontrunner in the Greater Mekong Subregion for comprehensive malaria surveillance.