Ebola: What the Data Say

After struggling through nearly eighteen months, 3,589 deaths, and 8,704 people infected, the World Health Organization (WHO) declared Sierra Leone free of Ebola transmission on November 7, 2015. A couple months later, Liberia was the first country in West Africa declared completely Ebola-free, a major step forward after more than 11,300 deaths in West Africa due to Ebola.

However, a single day after the Liberia announcement, Mariatu Jalloh, a 22-year-old student, was confirmed to have contracted and died from Ebola in Sierra Leone, where disease transmission was said to have stopped. A second case of Ebola in Sierra Leone was reported nine days later. The data systems in place for disease reporting made it clear that the epidemic was not yet over.

In early 2015, JSI’s Alimou Barry, senior health information systems specialist at the USAID-funded MEASURE Evaluation project, traveled to Guinea to study the impacts of Ebola on routine health systems. Focusing closely on Ebola’s impact on reproductive, maternal, and child health services, he found significant declines in the use of childhood services, ongoing shortages of medicines, and gaps in Ebola prevention training. During his assessment, however, Barry also found that medical data collection and reporting between health facilities and districts were organized and functioning well, but that the facility and district-level data were never collected and aggregated at the national level to be used by decision makers.

Barry believes that data were the essential ingredients that could have been used to fight Ebola in Guinea, but were not sufficiently available to policymakers addressing the crisis. Health information system (HIS) data needs to play a key role in disease surveillance and reporting for tracking new cases and potential outbreaks. Data available at the national level will be an essential means for West Africa to monitor, respond to, and prevent the return of the Ebola epidemic.

In a video on MEASURE Evaluation’s work in Guinea, Barry outlines three key suggestions to address the Ebola epidemic and its impacts:

• Communicate to the public that early care leads to better outcomes
• Ensure more prevention training for health professionals to protect themselves and their patients from transmitting the virus
• Strengthen community-level surveillance systems to provide an early warning system to decision makers, rather than focus on data only from health facilities.

Barry hopes that Guinea’s experiences with Ebola will provide guidance and better instruction as the government and health providers move forward. The recurring cases of Ebola in Sierra Leone and throughout West Africa, as pointed to earlier, will only be prevented with better management and monitoring of data at the national level. Improved organization of these data, through Barry’s work, will assist in better containing this epidemic.

Looking forward, MEASURE Evaluation will continue to work with health sector and development partners in the region to strengthen the ability of national data reporting systems to provide better data for decision making.

Written by Amanda Makulec and Tim McAuliffe