i Foreword The 2011 Health Information Bulletin is the sixth publication in the series of Health Bulletins produced by the Ministry of Health, Zanzibar through its Health Management Information System (HMIS) unit. The bulletin contains analyzed information predominantly from routine data collected from public and private health facilities, some survey data and health related studies during 2011. Collected data from health facilities and programmes are compiled electronically at the district using the District Health Information Software (DHIS2). The Data management process is done participatory involving programmes managements staffs, health facilities in charges, District Health Management Teams (DHMTs), HMIS staffs, Mnazi Mmoja Hospital management staffs and Private Health Facilities. Major areas covered in this report include details on International and National indicators namely – The Millennium Development Goals (MDG), Zanzibar Strategy for Growth and Reduction of Poverty (MKUZA) and Health Sector Annual work plan 2011 indicators. Sections on service utilization, data coverage and information from various programmes, and information on diseases surveillance are included. Programmes whose data are presented include Integrated reproductive and Child Health, Integrated HIV, AIDS, TB and Leprosy components. Information on disease surveillance including communicable, non communicable and neglected tropical diseases is also included. It is anticipated that this information will be used for monitoring and evaluation, local level planning and decisions making of the health sector for improvement of quality service provision and the subsequent enhancement of health care for meeting the public requirements. MOHAMMED S. JIDDAWI (MD) PRINCIPAL SECRETARY MINISTRY OF HEALTH ZANZIBAR i TABLE OF CONTENTS FOREWORD ........................................................................................................................................ I TABLE OF CONTENTS.....................................................................................................................II LIST OF TABLE............................................................................................................................... VII LIST OF FIGURES.............................................................................................................................IX LIST OF MAPS...................................................................................................................................IX ACKNOWLEDGEMENTS.................................................................................................................. X ACRONYMS........................................................................................................................................XI CHAPTER ONE................................................................................................................................... 1 1. INTRODUCTION....................................................................................................................... 1 CHAPTER TWO ................................................................................................................................. 2 2. SOURCES OF HMIS DATA, QUALITY AND COVERAGE ................................................. 2 2.1 Primary data (Routine HMIS)..................................................................................................................2 2.2 Types of Data captured by HMIS unit .....................................................................................................3 2.3 Coverage of report submission ...............................................................................................................3 2.4 Timeliness of Reporting – example from immunization data. ................................................................3 2.5 Data quality............................................................................................................................................4 CHAPTER THREE ............................................................................................................................. 5 3. HEALTH SYSTEM..................................................................................................................... 5 3.1 Hierarchy of Health System ....................................................................................................................5 3.2 Utilization rate........................................................................................................................................5 3.2.1 Facilities OPD utilization rate (All age).................................................................................................6 3.2.2 Facility OPD utilization rates under 5 years.........................................................................................6 CHAPTER FOUR................................................................................................................................ 8 ii 4. MDG, MKUZA & ZHSSP INDICATORS ................................................................................ 8 4.1 Millennium Development Goal (MDG) ...................................................................................................8 4.2 MKUZA & HSSP.......................................................................................................................................8 4.3 MKUZA II MONITORING........................................................................................................................12 CHAPTER FIVE................................................................................................................................14 5. DISEASE SURVEILLANCE ....................................................................................................14 5.1 Most common reported diagnosis for new patients under 5 years.......................................................14 5.2 Top 15 for age 5 years and above .........................................................................................................15 5.3 Common Diseases for all ages...............................................................................................................16 5.3.1 Pneumonia (prevalence) ...................................................................................................................16 5.3.2 Upper Respiratory Tract Infections (URTI) ........................................................................................17 5.4 Epidemic Diseases ................................................................................................................................18 5.4.1 Cholera ..............................................................................................................................................18 5.4.2 Dysentry (Diarrhoea with Blood).......................................................................................................19 CHAPTER SIX...................................................................................................................................20 6. NON COMMUNICABLE DISEASES (NCDS) ......................................................................20 6.1 NCD from Routine HMIS data ...............................................................................................................20 6.1.1 Diabetes Mellitus (DM) at Mnazi Mmoja Hosp. Diabetic Clinic.........................................................20 6.1.1.1 Number of Diabetic complications at Mnazi Mmoja in 2011 ..................................................21 6.1.2 Road Traffic Accident (RTA), 2011.....................................................................................................21 6.2 NCD risk factor survey 2011..................................................................................................................22 6.2.1 Selected risk factors and prevalence of NCDs ...................................................................................22 6.2.2 Some selected results for NCDs survey in Zanzibar...........................................................................23 6.2.1.1 Overweight and obesity...........................................................................................................23 6.2.1.2 Physical activity........................................................................................................................24 6.2.1.3 Combination of risk factors......................................................................................................24 6.2.1.4 Raised blood pressure / Hypertension.....................................................................................24 6.2.1.5 Raised Blood Glucose levels / Diabetes ...................................................................................24 6.2.1.6 Accidents and injuries ..............................................................................................................25 6.2.1.7 Mental health...........................................................................................................................25 CHAPTER SEVEN ............................................................................................................................26 7. CHILD HEALTH AND IMMUNISATION............................................................................26 7.1 Expanded Programme on Immunization (EPI).......................................................................................26