Anticipation and response: pandemic influenza in Malawi, 2009

Sambala, Evanson Z.; Manderson, Lenore

Linked to this, we identified the need to strengthen the health system because it is within this system that treatment and prevention are delivered. While financial and human resources are also needed to operate surveillance activities that support regular diagnoses of influenza and monitoring seasonal-like influenza through sentinel surveillance and laboratory tests, setting up and managing a good surveillance system for influenza in Malawi would not be a small task. Thus we suggest a number of cheap alternative types of surveillance could be used to survey and monitor influenza. For example, Outpatient Illness Surveillance was not emphasised by authorities in clinics or hospitals, and no information was stored or collected on flu patients visiting these institutions prior to the pandemic. No efforts were made to engage with alternative providers, which might have been critical had hospitals and clinics been overwhelmed with an unusually high number of patients. Preparedness plans need to take account of how the health sector can engage with different publics, traditional healers or volunteers from non-health sectors to reduce the demand and burden of patient care in case of surge turnout in crisis situations.