The Malaria Indicator Survey (MIS) was developed by the Monitoring and Evaluation Working Group (MERG) of Roll Back Malaria, an international partnership developed to coordinate global efforts to fight malaria. A stand-alone household survey, the MIS collects national and regional or provincial data from a representative sample of respondents.
The DHS Program co-chairs the MERG Survey and Indicator Guidance Task Force and has been a major contributor to the development of the MIS package. The MIS package includes questionnaires, manuals, and guidelines that are based on Demographic and Health Surveys materials. The DHS Program is also active in the implementation of the Malaria Indicator Survey and has developed a website to provide information about and data for Malaria Indicator Surveys worldwide. Standardized malaria indicators are also available for nearly 30 countries.
MIS collects data on all of the internationally recognized malaria indicators including:
- Household ownership of insecticide-treated mosquito nets and their use, especially by children under five years of age and pregnant women
- Intermittent preventive treatment against malaria during pregnancy
- The type and timing of treatment of high fever in children under five years of age
- Indoor residual spraying of insecticide to kill mosquitoes
- Diagnostic blood testing of children under five with fever.
The survey gathers additional information on indoor residual spraying (IRS), and background data on the characteristics of household members and ownership of household assets such as electricity, bicycles, radios, and indoor plumbing. Almost all of the questions in the MIS instrument were derived from the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys.
Depending on the needs of the country, the MIS can also include measurement of malaria parasites and anemia (a common result or malaria) among household members most at risk: children under five years and pregnant women. Specially trained interviewers take a few drops of blood from the fingers of eligible respondents who consent to the tests. The blood is immediately tested for anemia in the field and the results are provided to respondents within a few minutes. In Malaria Indicator Surveys, it is recommended that blood be tested for malaria with both a rapid diagnostic test in the field and microscopy in a laboratory. To date, anemia has been tested in more than 60 DHS and MIS surveys, and malaria prevalence has been tested in numerous MIS surveys, as well as several DHS surveys.
Timing of the MIS: Unlike the DHS, which is carried out at various times during the year, the MIS is usually timed to correspond with the high malaria transmission season. This is essential if the MIS includes biomarker testing for malaria.
Conducting a MIS: To help countries and organizations conduct a MIS, the Roll Back Malaria partnership has developed a MIS toolkit. This revised package contains guidelines, questionnaires, and manuals to support the conduct of the survey as well as recommended tabulations for analyzing the data.