Tropical Health Matters

By Emmanuel Fiagby in Accra, January 23, 2012, Voices for a Malaria-Free Future

The United Against Malaria (UAM) Partnership in Ghana being led by the Johns Hopkins University Center for Communication Program Voices for a Malaria-free Future project, the National Malaria Control Program and the Ghana Football Association held a special media event in Accra as a prelude to Ghana’s attempt to win the Africa Cup of Nations (AFCON) 2012 tournament currently taking place in Gabon and Equatorial Guinea. In the photo to the right we see Ghana’s NMCP Manager launching the UAM Malaria-Safe Playbook.

Held under the theme, “Partnership for Malaria Elimination – Winning the Africa Cup of Nations – AFCON 2012 and the fight to eliminate malaria,” the event brought together about 70 personalities representing 15 News papers, 6 Television stations/channels, 6 Radio stations, the National Sports Authority, the Ghana Football Association, the NMCP, WHO, USAID/PMI/CDC, Ministry of Information, Private Sector companies, academia and the Ghana Coalition of NGOs in Malaria.

In introducing the event, the Country Director of the Johns Hopkins University Voices Project Emmanuel Fiagbey reminded participants of the significance of tapping in to the enthusiasm and support for the national team the Black Stars to win the AFCON 2012 to promote greater advocacy for eliminating malaria from Ghana. “While football is the most popular sports in Ghana, malaria is the most popular killer, we need to employ the positive popularity of football to defeat the negative popularity of malaria,” he remarked.

In a statement to the event, Mr. Kwesi Nyantakyi, President of the Ghana Football Association reminded the audience and press members (seen in photo) that footballers are not immune to malaria. Malaria, he pointed out is a big threat to footballers and the practice of their profession. “Aside that we also think society has invested in us and we need to give back what society has invested in us. That is why we have decided to use the Ghana Football Association and football as a vehicle to disseminate information on malaria prevention and treatment,” he stated.

Presenting the key note address, Prof Fred Binka, a renowned Malariologist and Dean of the School of Public Health of the University of Ghana called on all stakeholders especially communities, civil society leaders and groups, NGOs, the media, local government agencies and development partners to ensure strict adherence to the use of ACTs in treating malaria. “The support of these groups will equally be crucial in lifting our education programs up two or more notches to encourage the use of LLINs by all Ghanaians in particular our children and pregnant women,” he emphasized.

With regards to funding challenges, Prof. Binka lamented the suspension of Global Fund Round 11 grants and opined that this could lead to loss of the gains so far made and malaria could be back with a heavy toll on especially children and pregnant women. He called for new partnerships from oil producing countries (OPEC) such as Saudi Arabia and new economic giants such as China to increase their resource support for malaria control and elimination in endemic countries.

Prof. Binka further stressed that the control and elimination of malaria will involve the contribution of every sector – from local government, education, employment and social welfare as well as private companies to the Ministry of Finance. “No sector can be excluded. Indeed we need a strong partnership with global initiatives, privately financed public sector projects, industry partnerships, local, regional and national partnerships led by civil society,” he accentuated.

In conclusion, Prof Binka hoped that the opportunity of the AFCON 2012, contest will energize several potential partners to accelerate their efforts to fight malaria by creating workplace malaria control policies and programs such as provision of treated bed nets and treatment services to their employees and dependants and adopting villages and whole districts within their catchment areas, working with them to reduce mosquito density and providing them with treatment and prevention services.

In launching a set of UAM branded malaria advocacy materials developed by the JHU/CCP/Voices project in partnership with the Ghana Football Association, Dr. Constance Bart-Plange, Manager of the National Malaria Control Program called on the Private Sector  companies to ensure the application of the Malaria-Safe Pillars of increased and continuing education, adherence to improved protection practices, greater visibility of efforts in order to attract added resources and promote effective advocacy. She charged the private companies in particular to endeavour to apply the 13 Winning Moves prescribed in the Winning Moves Chart, one of the materials launched. Other materials outdoored at the event included the 2012 edition of the GOAL Malaria Newspaper and the Malaria Safe Play Book – a Resource Guide for private companies.

In her concluding remarks, the Ag. Director General of the Ghana Health Service, Dr. Gloria Quansah Asare who chaired the event called on all malaria program managers, specialists and activists to remain ever committed and creative in the presentation of malaria information to the public as demonstrated by the Voices UAM Partnership. “The more efforts we put in the development and presentation of our health messages to our audiences the more successful we would be in making such messages acceptable and easy to adopt by our clientele, she emphasized.

About United Against Malaria: Founded in the lead–up to the 2010 FIFA World Cup South Africa, United Against Malaria is an alliance of football teams and heroes, celebrities, health and advocacy organizations, governments and corporations who have united together to end malaria deaths by 2015. We have the tools and the momentum. United, we can beat malaria.

Malaria incidence and prevalence has been dropping quickly in Rwanda, below 2% in children under 5 years old. Malaria in Pregnancy (MIP) is still a risk some and may be more severe as the disease becomes rare and immunity reduces. The US President’s Malaria Initiative is supporting a prevalence study of MIP through its Maternal and Child Health Integrated Program (MCHIP) and the National Malaria Control Program (NMCP) so that appropriate data will become available to design appropriate MIP interventions as the country moves towards malaria elimination.

The study focuses on pregnant women during their first visit to focused antenatal care (FANC) for their current pregnancy. Four FANC visits promote maternal and newborn health through 1) Early detection and treatment, 2) Prevention of complications and disease, 3) Birth preparedness and 4) Health promotion.

The study of over 4000 women is at the half way mark. Supervisory visits determine if data such as RDT, Microscopy and PCR tests, are being gathered correctly.

Pictured here are Alice and Donatien who are nurses based at Gakoma Health center in Gisagara District and were trained for the the MIP prevalence study. They are seen here taking blood samples for the study. They have integrated the study procedures into the routine FANC they provide. This makes it easier for the client as well as the nurses who also extract study data on age, parity, hemoglobin, bednet ownership and fever history which is normally collected as part of FANC.

Since data collection began in late December, Alice and Donatien have enrolled about half of their target number of clients.  When the results from all 38 health centers across the country are compiled in April, the National Malaria Control Program will have valuable information to plan how best to protect pregnant women as the country moves closer to malaria elimination.

Agente Santé Maternelle (ASM) are one of four types of Rwandan Community Health Workers (CHWs) which include community case management and social mobilization workers who are selected by their own villagers and serve as volunteers.

ASM identify, follow, educate and refer pregnant women in their villages to the nearest health center. During the USAID ACCESS Project in Rwanda, Jhpiego assisted the Ministry of Health to adapt UNICEF training materials for ASMs. MCHIP is continuing the work and focuses on training and kitting ASMs in five Districts.

Alphonsine, an ASM from Karubondo village near Gikondo Health Center keeps a record book of pregnant women she is following. Her village has 179 households, 696 residents and 124 women of reproductive age (WRA).

The program ensures that ASM have manageable case loads. Since her training by MCHIP in August 2011, Alphonsine has seen 17 clients and now is following 9 pregnant women.

Health education materials such as a flipchart for the ASMs include emphasis on bednet use and prompt treatment of fevers. AMS also have a carry bag, boots, umbrella, thermometer, and a torch.

Some women are reluctant to reveal their pregnancies because of social issues like being a widow or a teenager. The AMS must work hard to gain trust so women confide in her. Volunteer work as ASM must fit in with her hard work as a farmer.

ASMs encourage women to attend Antenatal Care at nearest clinic. There they will reveive free bednets. The ASM then educates the women on proper and regular net use. The ASM also refers women with danger signs in pregnancy to ANC. Such signs may be high temperature for which proper testing and treatment is needed if they have malaria.

Rwanda is closing in on malaria elimination. The various kinds of CHWs play an important role in prevention, case detection and assurance of appropriate treatment. Community vigilance is a crucial component of eliminating the disease.