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Ambitious new goals for control of malaria have been set and significant additional resources for malaria control are being mobilized. Yet for many of the countries most severely burdened by malaria, both baseline data and reliable monitoring of key impact indicators is lacking. For such countries, it will be difficult to know when targets are met or whether to make mid-course corrections if progress is inadequate. The new investments in malaria control have triggered resurgence in demand for health information, both for performance-based resource allocation and for health impact. We argue here that some of these resources will need to be diverted to support more integrated information systems able to monitor change and guide approaches, not just for malaria, but also for other important health and poverty related interventions. This paper urges a re-thinking of the nature of management information systems and sources in resource poor settings. A pathway is suggested that helps situate monitoring and evaluation more strategically in a framework of other information management steps for longitudinal, iterative, evidence-based decision making. Health Information Systems of the future will need much greater coherence in the use of information from disparate sources and much greater influence on action.
Received August 21, 2003. Accepted for publication January 14, 2004.
Acknowledgment: The paper is based on an invited presentation by Don de Savigny at the Third Multilateral Initiative on Malaria, Pan-African Conference, Arusha, Tanzania, November 2002.
Disclosure: Fred Binka is the Executive Director of the INDEPTH network.
Authors addresses: Don de Savigny, Swiss Tropical Institute, Box 4002, Basel, Switzerland, Telephone: 41-61-284-8221, Fax: 41-61-271-7951, E-mail: d.desavigny{at}unibas.ch. Fred Binka, INDEPTH Network, 9 Adenkum Loop, Kanda, Box 14550, Accra, Ghana, Telephone: 233-21-254-752, Fax: 233-21-254-755, E-mail: indepth{at}africaonline.com.gh.
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