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When do more health facilities result in more malaria?

January 9, 2013 - 14:41 -- William Jobin

Epidemiological nugget three;

Let us suppose that in 2013 Huila Province in southern Angola expands its health care system by 25%, using increasing funds from national oil and mining revenues. Thus Huila Province in 2013 will have 62 health posts reporting, instead of the 50 they had in 2012. If the new health posts each are staffed with a number of new nurses equal to those in the existing 50 posts, then the average number of patients they each see each day will be about the same, and they will thus report about the same number of malaria cases, let us say 10 per day per post. The health post reports will be passed up the line, eventually to the main MOH office in Luanda.

The MOH in Luanda will then pass the data directly to WHO Geneva, who will then tell us that in 2013 Angola was reporting 620 cases of malaria per day, instead of the 500 cases per day that they had reported in 2012, and will alert us to the 25% increase in malaria in Angola!

It is all very logical - and meaningless - because of the way WHO acquires and analyzes national data on malaria incidence. Is it any wonder that people no longer depend on WHO for accurate malaria data?