EVALUATION OF NATIONAL MALARIA CONTROL PROGRAMS IN AFRICA

Evaluation is an essential management tool for the improvement of publ ic health programmes or projects. As malaria morbidity and mortality c ontinue to increase in most countries in Africa, international agencie s and malaria control programme managers have identified the strengthe ning of programme evaluation as an important strategy for improving th e efficiency and effectiveness of malaria control programmes. Managers can develop an evaluation strategy only after they have defined progr amme objectives and planned specific programme activities. Indicators should be directly related to programme objectives and should be selec ted on the basis of the following criteria: their validity; reliabilit y; ability to detect change within a reasonable time period and as a r esult of successful programme implementation; ability to be interprete d; and usefulness in guiding programme change. Only those indicators t hat can be measured with available programme resources should be selec ted. Managers will also need to identify the sources of indicator data and to determine how often each indicator will be measured. Programme managers should develop criteria or indicators for the following: pro gramme policies and plans; the process of programme implementation; th e outcomes of malaria control interventions in disease management and prevention; and programme impact in terms of reductions in malaria-rel ated mortality and morbidity. Key issues related to the management of evaluation activities within a national programme include the need to begin with available resources and build incrementally, to explore opt ions for administering evaluation activities; to select, train and sup ervise staff who carry out evaluation activities; to develop quality c ontrol strategies; and to ensure that data are managed and communicate d in ways that support effective programme decision-making. For evalua tion to lead to improvements in malaria control programmes it must be clearly defined as a part of the programme management process. Program me managers should lead this developmental process, ensuring that eval uation methods produce the information they need to monitor and improv e their programmes at reasonable cost.