World Malaria Day 2012: Making Progress in Africa

Focusing on the theme, "Sustain Gains, Save Lives: Invest in Malaria," this year's World Malaria Day, held annually on April 25, recognizes the decade's achievements in reducing malaria deaths and the importance of sustaining this progress. According to the World Health Organization, deaths caused by malaria fell by a quarter globally over the last decade, and by more than a third in the African region. Yet an estimated 650,000 people died as a result of malaria in 2010, most of them young children in Africa.

University Research Co., LLC (URC) supports efforts to combat malaria in Africa by helping to prevent and control malaria in Ghana and to improve diagnosis and management of malaria cases in young children in Tanzania.

Reducing Malaria's Impact in Ghana

Malaria is the primary cause of morbidity and mortality in Ghana and accounts for more than three million outpatient visits to public health facilities every year.  The Promoting Malaria Prevention and Treatment (ProMPT) project, funded by the US Agency for International Development (USAID) through the President's Malaria Initiative, works with the country's National Malaria Control Program to strengthen malaria prevention and control and to scale up proven malaria interventions. 

ProMPT helps reduce malaria's impact on Ghana through four major approaches:

  1. Door-to-Door Long-Lasting Insecticidal Net (LLIN) Hang-Up Campaigns
    Distributing and hanging bed nets is a key strategy to combating malaria. Insecticide-treated nets kill the mosquitoes that transmit malaria on contact and prevent them from biting people that sleep under the nets at night, when the mosquitoes are most active.  ProMPT developed an innovative model for engaging governments, non-governmental organizations (NGOs), community leaders, and volunteers for regional door-to-door LLIN hang-up campaigns for every household in the country.  Door-to-door LLIN hang-up campaigns provide opportunities that other distribution strategies do not: while hanging bed nets over sleeping places, volunteers also inform residents about the benefits of routinely sleeping under the nets and teach people how to care for them. Through the door-to-door hang-up approach, LLIN ownership increased from about 30% to over 80% of households in one region. (Analysts estimate that the campaign contributed to more than 70% of the observed increase.)  To date, campaigns have been carried in six of Ghana's ten regions, with more than 7 million LLINs distributed and hung; these campaigns will expand to all regions by the end of 2012. Malaria No More (UK), an organization that works closely with ProMPT on the LLIN campaigns, produced a video that illustrates this work.
  2. Social Mobilization
    Because malaria is such a common disease in Ghana, many people are unaware of the dangers it presents and do not know how to prevent it. ProMPT has initiated a number of social mobilization activities to educate Ghanaians about malaria prevention and treatment and to encourage communities to take an active role in combating the disease. For example, ProMPT supported faith-based organizations and NGOs to reach out to more than 1.5 million people with information.  ProMPT also trained traditional and opinion leaders, enabling education on malaria at the community level.
  3. Case Management and Malaria in Pregnancy (MIP)
    ProMPT is strengthening the capacity of Ghana's health facilities to prevent and treat malaria.  The project works to ensure that health care workers learn how to effectively manage malaria during pregnancy—to make sure pregnant women take a preventative drug called SP and sleep under LLINs every night.  Health workers learn how to diagnose malaria and which medicines are most effective in treating the disease. ProMPT trained nearly 9,000 of Ghana's health workers in malaria case management and MIP.
  4. Strengthening Health System Response and Monitoring and Evaluation
    Good quality malaria data helps the National Malaria Control Program to understand the malaria situation and take the actions needed to control it. ProMPT supports the national health system in building its capacity to monitor and evaluate the ongoing malaria prevention and control activities, conducting trainings for more than 100 health information officers and malaria focal persons in data management.

Strengthening Child Health Services in Tanzania's Lake Zone Region

The sudden onset of fever, called febrile illness, is often the first symptom of an infection—in this region, one usually caused by malaria, pneumonia, and/or diarrhea. Because progression to severe malaria is rapid and children may die within 48 hours if left untreated, it is essential that young children in the Lake Zone that develop a fever get assessed by a health worker.

According to the 2010 Tanzania Demographic and Health Survey, a third of children under five in the Lake Zone experienced fever in the two weeks prior to the survey; of these, less than half received advice or treatment from a health facility or health provider. The USAID-funded Diagnosis and Management of Severe Febrile Illness project is working to increase this number. Operating under the Swahili name, "Tibu Homa," meaning treat fever, the project is partnering with Management Sciences for Health and the African Medical Research Foundation to: 

  • Increase the availability of and access to basic facility-based child health services;
  • Ensure sustainability of critical child health activities; and
  • Strengthen links within the local community to promote healthy behaviors, thereby increasing knowledge and use of these services when they are needed.

To date, the project, which began last year, has trained 59 facility-level quality improvement teams in 15 hospitals and 44 health facilities on improved malaria case management using the improvement collaborative method. Through this method, teams from different clinics, hospitals, and other levels of the health system work together on common aims to improve particular aspects of the system. They share their experiences as they test changes for improvement, and then apply the successful changes on a wider scale. This year, Tibu Homa will expand to about 130 health facilities in nine additional districts, with an overall aim to reach 930 facilities within five years.

Tibu Homa is also working in collaboration with the regional and district health teams in local health centers and dispensaries in the Lake Zone to ensure that they can effectively manage and provide quality care for malaria cases among children in the local community.  This collaboration aims to build facility-community partnerships that will allow gains made by the project to be sustained in the long term. 

Kate Howell is the Knowledge Management Specialist for the International Development Group (IDG). Victor Masbayi is the Chief of Party for Tibu Homa. Nancy Newton is the Senior Advisor, Behavior Change and Communication for IDG.  Sarah Whitmarsh is Communications Specialist for URC.

Volunteers in Ghana hang LLINs while educating residents on using and caring for the nets. Photo credit: Kate Howell, URC.
Volunteers in Ghana hang LLINs while educating residents on using and caring for the nets. Photo credit: Kate Howell, URC.
Date 
April 25, 2012
Authors 
Kate Howell, Victor Masbayi, Nancy Newton, and Sarah Whitmarsh
Regions/ Countries