Tuesday, January 15, 2008

Empirical Analysis in anti-malaria activities

I am an ardent advocate of applying the Freakonomics methods in analysing public issues and in policy making. This post is a very strong live example of the utility of statistical analysis in governance. In one of my earliest posts, I had outlined how the Vijayawada Municipal Corporation (VMC) had initiated an anti-malaria drive in the city by utilizing certain simple techniques of statistical analysis. Without focussing on the details of how the success was achieved, I will merely flag off the utility of data analysis in addressing the malaria incidence.

Briefly, Vijayawada city is highly malaria endemic, and there used to be 5000 to 6000 positive cases detected in the City every year. The Malaria circle in VMC was divided into 53 sections which were serviced with equal intensity (or lack of it) by the Malaria Wing. But a close scrutiny of the Malaria trends in the 53 sections over a five year period, revealed certain startling conclusions.

It was found that a major proportion of the positive cases came from 10 sections. Within these 10 sections too, colony and street wise analysis was done to localize the prevalence. It was therefore decided in 2006 to give specific focus to anti-malaria activities in these 10 sections. A range of activities were initiated in these areas to address the problem. The next year, following the success of the experiment in these 10 sections, it was decided to give similar focus for the next vulnerable 12 sections.

Spurred by the success of these methods, which were first initiated in September 2005, a major Malaria Free Vijayawada 2011 campaign was launched in August 2007. The objective was to focus the application of these successful methods to cover the entire city and eradicate Malaria from Vijayawada. As a result, in addition to the original 22, another 8 vulnerable sections have been identified for intensified anti-malaria activities. These 30 sections constitute more than 90% of the positive cases in the 53 sections of the City.

The results have been nothing short of spectacular. While the number of positive cases detected were 6271 in 2005, it fell 53.4% to 2921 in 2006, and 40.15% to 1748 in 2007. In the 10 most endemic sections where these methods were initiated in mid-2005, it fell 54.4% from 2652 in 2005 to 1129 in 2006, and 28.6% to 805 in 2007. In the 12 next vulnerable sections where the campaign was initiated in January 2007, it fell 34.4% from 752 to 493. During the tree years, the blood smear collection samples too increased.

All this was achieved at reduced cost, compared to the previous years. The focus of anti-malaria activities was shifted to anti-larval and other preventive activities. Hitherto anti-malaria activites focussed heavily on Malathion fogging, which despite being found to be both ineffective and harmful to public health, continues to be the predominant focus in many areas. There are strong vested interests in ensuring its continuation, given the relatively higher costs of such activities. Malathion consumption fell from 9580 litres in 2005 to just 299.5 l in 2007. In contrast, reflecting the increased focus on anti-larval activities, the consumption of chemicals like Baytex, Pyrethrum, and Abate increased.

The aforementioned example is a simple illustration of the efficacy of data analysis in solving local problems. This approach can be an invaluable tool in identifying and then tackling many local problems and deficiencies in health and education sectors, especially given the wealth of information available with the respective departments.

No comments: