Factors associated with private health facilities reporting malaria in the national health management information system in Zambia: a cross sectional study

Introduction Zambia has moved from accelerated malaria burden reduction to malaria elimination which requires the national malaria surveillance system to capture all cases from both the public and private sector. This study investigated challenges and factors associated with private health facilities reporting malaria in the national health management information system (HMIS). Methods a structured questionnaire was administered to the heads of 139 private health facilities in three provinces where approximately 85% of private health facilities are found in Zambia. Logistic regression was performed, and the outcome variable was reporting malaria in the HMIS. Epi Info® version 7 was used to conduct multivariable logistic regression to determine factors associated with private facilities reporting malaria in HMIS. Results private health facilities that had been operating for more than 20 years had three (3) times increased odds of reporting malaria in HMIS (AOR = 3.22, 95% CI: 1.23, 8.42; P-value = 0.02) compared to those that had been operating for less than 20 years. The private facilities that had staff who were aware about malaria surveillance (AOR = 2.06 95% CI: 1.38, 3.99, P-value = 0.01) had two times greater odds to report malaria in HMIS compared to those that were not aware. Lack of information and training in surveillance was identified as the main barrier for private facilities to report malaria in HMIS. Conclusion as Zambia progresses towards malaria elimination, there is need to increase awareness and training of private providers on malaria surveillance to improve reporting in HMIS.