From a peak of nearly 40,000 malaria cases in 1994, malaria case incidence in Bhutan is on a progressive decline. With a total of just 62 positive malaria patients in 2017, Vector-borne Disease Control Program (VDCP) of the Royal ministry of Health, Bhutan has shown an exemplary commitment in their efforts towards malaria elimination in the country. Mostly confined geographically to the seven districts in southern part of Bhutan and the positive case incidence being attributed majorly by its migratory population, VDCP identified a need to establish an integrated Malaria case and Foci tracking system, for a stronger surveillance and monitoring of their efforts in these actively transmitting foci and keeping track of case incidence. This is further allows tracking the movement of all identified positive cases and ensuring follow-up of all malaria patients treated in their facilities.
Starting with a visit in Bhutan by experts from Global Malaria Programme/ WHO Geneva and WHO/SEARO in April 2018, this project was assumed to establish a DHIS2-based Malaria tracking system for supporting malaria elimination efforts of WHO & VDCP in the Royal Kingdom of Bhutan.
With an experience of supporting Bhutan with setting-up of their HMIS and MCH tracking system on DHIS2 through past project assignments and having a vivid experience in implementation of DHIS2-based disease surveillance systems across different countries, HISP India was chosen as the most suitable partner for delivery of the agreed deliverable for this project and an ‘Agreement for Performance of Work’ was signed between WHO-SEARO and HISP India on 16th July 2018 to support in this project conceptualization, development, piloting and a scale-up implementation across the country.
After a successful system development based on initial program requirements, a national level orientation workshop was organized in Paro from 3rd - 7th Sept’ 2018 with participants from VDCP, HMIS, RCDC and ICTD divisions of the Ministry of Health, Bhutan.
In this 5-day long workshop, participants were acquainted hands-on with this malaria tracker, using both web & android to enter dummy data in the system, followed with using analytical capacities of DHIS2 and demonstration of standard WHO Elimination dashboards. Feedback collected during this workshop was incorporated and a 3-month long piloting was successfully done in 3 high endemic districts, i.e. Sarpang, S. Jonkar and Samtse. With the post pilot feedback received and incorporated in January 2018, system was further migrated to the country’s DITT server and incorporated with their HMIS portal. Starting with their first phase user trainings in April 2019, this system is now is being scaled across the country and HISP India is concurrently supporting VDCP in this implementation.
As one of the accolades received by this projects, Dr. Tobgyel Dukpa (Dy Chief Program Officer, VDCP) was invited to present this Malaria Tracking system of Bhutan as a best practice use case for data use in Malaria elimination by a country at the South East Asia Regional Workshop in Bangkok on ‘Strengthening data demand and use for impact’ in February 2019, which gathered much appreciations from the countries across SEARO. It is further planned to be included as a successful WHO Malaria tracker implementation use case in the DHIS2 Experts Academy, 2019 at UiO.