Factors Associated with Private Health Facilities Reporting Malaria in the National Health Management Information System in Zambia: A Cross Sectional Study

  • Vector-borne
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Background:
Zambia’s goal is to eliminate malaria in the year 2021. This requires the malaria surveillance system to capture all cases from both the public and private sectors. However, less than 40% of private facilities report on malaria in the Health Management Information System (HMIS). This study investigated factors associated with private health facilities reporting malaria in HMIS
Methods:
A cross-sectional study was conducted in the year 2018, in three provinces where approximately 85% of private facilities are found in Zambia. Of the 304 private facilities offering malaria services, a sample size of 139 (CI: 95%) was determined. A questionnaire, which included questions on years of operation, human resource and malaria surveillance, was administered to the heads of the randomly selected private facilities. The outcome variable was reporting malaria in the HMIS (defined as a private facility that submits their monthly reports to the district health office). Multivariable logistic regression was applied.
Results:
Data were collected from 139 private facilities. Few (n=12/139, 9%) private facilities had someone trained in malaria surveillance. Private facility that had ≥5 nurses (AOR=4.92, 95% CI: 2.03, 11.93; P-value <0.01), operated for ≥20 years (AOR=3.22, 95% CI: 1.23, 8.42; P-value 0.02) had increased odds of reporting malaria in the HMIS compared to those that had been operating for <20 years. The heads of the private facilities that were aware of malaria surveillance had increased odds of reporting malaria in the HMIS (AOR=2.06 95% CI: 1.38, 3.99, P-value 0.01) compared to those that were not aware.
Conclusion
The private facilities that had ≥5 nurses; operated for ≥20 years and the heads of the private facilities being aware of malaria surveillance was associated with reporting malaria in HMIS. We recommend increasing the number of staff and training of private providers on malaria surveillance to improve reporting in the HMIS.

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