The overall goal for Division of National Malaria Program is to reduce the Malaria incidence and Deaths by at least 75% of the 2016 levels by 2023 through access to appropriate malaria interventions, manage 100% of suspected malaria cases according to Kenya Malaria Treatment Guidelines and to strengthen malaria surveillance and use of information to improve decision making (KMS, 2019). To achieve these, there is need to closely monitor the malaria data from all levels of reporting to ensure timely and effective interventions. Data quality, therefore, is paramount in the attainment of the program’s objectives. The success in controlling and reducing malaria incidence cases and deaths in endemic counties is dependent on reliable surveillance, monitoring and evaluation of systems put in place with generation of high-quality data that can be relied on.

Kakamega and Vihiga Counties are both malaria-endemic counties located in the Western part of Kenya. Malaria is among the leading causes of morbidity and mortality in both counties. They border other malaria endemic counties in the lake endemic region. The incidence of malaria in these two counties increases during the long rainy seasons.

Data from the Kenya Health Information System (KHIS) shows discrepancies in the number of tested and confirmed malaria cases in the monthly outpatient summary (MOH 705 A and B) and the monthly laboratory report (MOH 706) in both counties. For instance, the MOH 705 shows that between August 2020 and July 2021, Kakamega County had a total of 904,898 tests conducted, whereas the MOH 706 gives a figure of 643,110, about 29% lower; the number of confirmed cases is 666,146 and 239,640 for MOH 705 and MOH 706 respectively. Data gaps were also noted, since the uploaded outpatient summary in the online platform doesn’t have data on the number of tested individuals in August and September 2020. On the other hand, Vihiga County reported 156,746 confirmed cases in the outpatient summary (MOH 705) versus 45,718 in the laboratory summary for the period between August 2020 and July 2021. Unpublished findings from a similar exercise in the coastal endemic county of Kwale found that source documents completion rate was 42% while monthly report timeliness was 58%, with both under-reporting and over-reporting were noted.

Poor data quality may be as a result of misdiagnosis (Afrane et al., 2013), gaps in definition of indicators (Okello et al., 2019), commodity stock-outs and staffing challenges (Okello et al., 2018), among other reasons. It may lead to over-estimation or under-estimation of disease burden, with resultant consequences in terms of priority setting, planning, resource allocation, and missed opportunities.

A team from Kenya Field Epidemiology Training Program (K-FELTP) and Division of National Malaria Program (DNMP) was thus deployed to assess the quality of malaria data in health facilities in Kakamega and Vihiga Counties.

The specific objectives of the investigation were;

• To conduct malaria data quality assessment in selected health facilities in Kakamega and Vihiga Counties
• To identify possible factors influencing malaria data quality in Kakamega and Vihiga Counties.

The assessment was conducted within a period of 14 days from 17th September 2021. The investigation population consisted of records of suspected malaria cases and healthcare workers in selected health facilities in both counties. The investigation involved conducting malaria data quality assessment in selected health facilities in the county using the revised digital malaria routine Data Quality Assessment (rDQA) tool. The team visited each sub-county in the two counties. The facilities targeted in each county included the county referral hospital, at least 2 sub-county hospitals, at least 2 health centers, at least 2 dispensaries, and at least 1 private health facility and 1 major faith-based health facility.

In each facility, the following registers and reporting tools were used to obtain data on malaria tests and cases between June and August 2021: Outpatient registers, Outpatient monthly summary tools, Laboratory register (MOH 240), Laboratory monthly summary tool (MOH 706), Malaria commodities daily activity register (DAR, MOH 645), and the malaria commodities monthly summary tool (MOH 743). The web-based reporting system, Kenya Health Information System (KHIS), was also be accessed to confirm reported data for the periods under review.