Category Archives: Advocacy

Global Civil Society for Malaria Elimination (CS4ME)

CS4ME was created during the Global Malaria Civil Society Strategising and Advocacy Pre-Meeting jointly convened by the Global Fund Advocates Network Asia-Pacific (GFAN AP) and APCASO held on 29th and 30th June 2018, prior to the First Malaria Wor1d Congress in Melbourne, Australia, with the support of the Malaria World Congress, Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Burnet Institute. An interim working group mode up of individuals that attended the Pre-Meeting was established to coordinate, recommend processes and mechanisms, identify resources and support necessary for CS4ME going forward.  For more Information please contact Ms Olivia Ngou Zongue <ngouolivia@gmail.com> of the Interim Working Group of CS4ME for further information. The Declaration arising from their meeting if provided below.

GLOBAL CIVIL SOCIETY FOR MALARIA ELIMINATION (CS4ME) DECLARATION
MALARIA WORLD CONGRESS 1ST-5TH JULY 2018
MELBOURNE, AUSTRALIA

Firm in the belief that empowered community and civil society are game-changers in health responses,  we, representatives of national, regional and global malaria communities and civil society attending the First Malaria World Congress, have come together and formed the Global Civil Society for Malaria Elimination (CS4ME) as part of our commitment to joint advocacy for more effective, sustainable, people-centred, rights-based, equitable, and inclusive malaria programmes and Interventions.

At a time when the world has the resources and tools to prevent and treat malaria, it is unconscionable how people – mainly from impoverished, vulnerable and underserved communities – continue to die from the disease. While we commend the efforts of governments and the international community that brought the world closer to malaria elimination, we call for greater accountability, political will and action, resource investments, and sense of urgency to eliminate the disease.

CS4ME makes the following call to the governments of implementing countries, donor countries and other duty bearers:

FRAME MALARIA RESPONSES IN THE CONTEXT Of SOCIAL JUSTICE AND HUMAN RIGHTS, AND WITHIN UNIVERSAL HEALTH COVERAGE

Significant progress has been attained during the past 10 years to reduce the burden of malaria throughout the world and in working towards achieving malaria elimination. As countries enter into the elimination phase, we see again and again the epidemic concentrating among the most marginalised, remote, and disenfranchised communities. In South East Asia, the concentration of malaria among communities barred from accessing quality and affordable health services has accelerated the emergence of drug resistance that now threatens the wor1d at large. Everywhere, the last mile of elimination becomes a matter of access to health for impoverished and marginalised communities, in particular, refugees, ethnic minorities, indigenous communities, migrant and mobile populations – with many of the risks faced by these groups compounded further amongst women and girls.

Including the most local, represents a strategic investment contributing to appropriate, effective service delivery and people-driven surveillance and response.
We call on national governments, international institutions, bilateral and multilateral donors to prioritise and increase funding allocations for community-driven community and civil society initiatives. We request that specific funding streams be made available to community groups, and their access supported through peer-to-peer technical assistance.

Furthermore, we request that key performance indicators that enable accountability for bringing malaria services to the underserved be developed and implemented.

PARTNER WITH CIVIL SOCIETY AND COMMUNITY ACTORS FOR AN EFFECTIVE MALARIA SURVEILLANCE AND RESPONSE

As surveillance becomes an essential pillar for malaria elimination, the need for timely and robust data is increasingly critical. Essential evidence includes routine data, qualitative and quantitative research, as well as experience, lessons learned and the voices from affected communities. Support is required to build the ability of civil society to generate evidence, as well as to communicate it effectively to ensure that community-generated evidence will be able to influence decisions and result in sustained change.
To eliminate malaria, surveillance requires a response. Communities and civil society are the first responders, and will have the clearest insight Into what responses are effective in their context or on behalf of their constituents.

We demand that communities and civil society organisations be given equitable access to data and other information that can inform field-level response. We call for transparent information systems and multi-directional information flows in order to enable dialogue, and inform decisions at all levels. We urge the building up of surveillance systems that involve communities as analysts, advisors, decision-makers and responders.

We, malaria communities and civil society, offer our support, expertise, and lived experiences In contributing towards our shared vision of malaria elimination. We are fully committed to working alongside other stakeholders to build stronger, more inclusive and effective partnerships and sustainable responses towards elimination of malaria in this lifetime.

Burkina Faso Celebrated World Malaria Day with Pledges to Defeat Malaria

Burkina Faso celebrated World Malaria Day with pledges to Defeat Malaria on 25th April 2018. Dr Ousman Badolo. Technical Director of Jhpiego’s USAID/PMI Supported Improving Malaria Care (IMC) Project describes below the event in the village of Kamboinsin, not far from the capital, Ouagadougou. Ibrahim Sawadogo from IMC provided the photographs.

The day started with a proclamation of malaria day from Burkina Faso’s President, Roch Marc Christian Kaboré, to his assembled cabinet and the press. The president recognized that malaria is still a major public health issue in the country, and while deaths are decreasing, the incidence of malaria is not. The President called for a greater commitment of resources by all partners to insure that malaria can be defeated in Burkina Faso by 2030.

Kamboinsin village in Sig-Noghin Health District was the site of further observances organized by the National Malaria Control Program, later that afternoon. This district was chosen because of having among the highest incidence rates for malaria in the region. Many partners set up booths to share their work in malaria with partners and citizens of the district. Included were three research centers (Centre Muraz, CNRFP and IRD), and three USAID programs supported by the President’s Malaria Initiative in Burkina Faso (Procurement and Supply Management [PSM], IMC and VectorLink), among others.

During the program both the Minister for Health and the US Ambassador spoke. The Minister highlighted the main strategies that Burkina Faso is employing to reduce and eliminate malaria including regular use of insecticide treated nets (ITN), seasonal malaria chemoprevention, Intermittent Preventive Treatment in Pregnancy (IPTp), Prompt and Appropriate Case Management and other Vector Control Strategies.

The US Ambassador shared a real-life story of a pregnant woman who during her current pregnancy decided to register early for Antenatal Care (ANC) as encouraged by the IMC project. She was able to get several doses of IPTp as required as well as obtain an ITN on her first visit, unlike in her previous pregnancies.

Entertainment was provided by the comedian Hypolythe Wangrawa (alias M’ba Bouanga) who presented a sketch involving his ‘son’ who was not encouraging his wife to attend ANC and receive malaria prevention services. M’ba Bouanga chastised the son and an actor playing a midwife explained to the family the value of attending ANC and preventing malaria. Singers Maria Bissongo, Miss Oueora and Aicha Junior provided the audience with a song that embodied a variety of malaria prevention and care messages.

A highlight of the occasion was recognition of high performing health districts in the country. They were judged on criteria including good management of malaria commodity stocks, reduced case fatality rates, use of diagnostic tests to confirm malaria before treatment and coverage of at least three doses of IPTp. Four districts were given awards, Titao, Thyou, Boussouma and Batie, while Charles de Gaul Pediatric Hospital was also recognized.

One can watch a video of the proclamation by the President on the National Facebook page. More details of the events are found in the following media: Lefaso.net and Paalga Observer.

World Malaria Day in Burkina Faso demonstrated the political will and commitment to “defeat malaria.” More and more national resources will be needed to reach the endline in 2030.

On World Malaria Day the realities of resurgence should energize the call to ‘Beat Malaria’

Dr Pedro Alonso who directed the World Health Organization’s Global Malaria Program, has had several opportunities in the past two weeks to remind the global community that complacency on malaria control and elimination must not take hold as there are still over 400,000 deaths globally from malaria each year. At the Seventh Multilateral Initiative for Malaria Conference (MIM) in Dakar, Dr Alonso drew attention to the challenges revealed in the most recent World Malaria Report (WMR). While there have been decreases in deaths, there are places where the number of actual cases is increasing.

Around twenty years ago the course of malaria changed with the holding of the first MIM, also in Dakar and the establishment of the Roll Bank Malaria (RBM) Partnership. These were followed in short order by the Abuja Declaration that set targets for 2010 and embodied political in endemic countries, as well as major funding mechanisms such as the Global Fund to fight AIDS, TB and Malaria. This spurred what has been termed a ‘Golden Decade’ of increasing investment and intervention coverage, leading to decreasing malaria morbidity and mortality. The Millennium Development Goals provided additional impetus to reduce the toll of malaria by 2015.

On Facebook Live yesterday Dr Alonso talked about that ‘Golden Decade.’ There was a 60% decrease in mortality and a 40% decreases in malaria cases. But progress slowing down and we may be stalled at a crossroads. He noted that history show unless accelerate efforts, malaria will come back with a vengeance. Not only is renewed political leadership and funding, particularly from affected countries needed, but we also need new tools. Dr Alonso explained that the existing tools allowed 7m deaths be diverted in that golden decade, but these tools are not perfect. We are reaching limits on these tools such that we need R&D for tools to enable quantum leap forward. Even old tools like nets are threatened by insecticide resistance, and research on alternative safe insecticides is crucial.

Dr Alonso at MIM pointed to the worrying fact that investment in malaria overall peaked in 2013. Investment by endemic countries themselves has remained stable throughout and never gone reached $1 billion despite advocacy and leadership groups like the Africa Leaders Malaria Alliance. The 2017 WMR shows that while 16 countries achieved a greater that 20% reduction in malaria cases, 25 saw a greater that 20% increase in cases. The outnumbering of decreasing countries by increasing was 4 to 8 in Africa, the region with the highest burden of the disease. Overall 24 African countries saw increases in cases between 2015 and 2016 versus 5 that saw a decrease. A review of the Demographic and Health and the Malaria Information Surveys in recent years show that most countries continue to have difficulty coming close to the Abuja 2010 targets for Insecticide treated net (ITN) use, prompt and appropriate malaria case management and intermittent preventive treatment of malaria in pregnancy (IPTp).

The coverage gap is real. The WMR shows that while there have been small but steady increase in 3 doses of IPTp, coverage of the first dose has leveled off. Also while ownership of a net by households has increased, less than half of households have at least one net for every two residents.

In contrast a new form of IPT – seasonal malaria chemoprevention (SMC) for children in the Sahel countries has taken off with over 90% of children receiving at least one of the monthly doses during the high transmission season. Community case management is taking off as is increased use of rapid diagnostic testing. Increased access to care may explain how in spite of increased cases, deaths can be reduced. This situation could change rapidly if drug resistance spreads.

While some international partners are stepping up, we are far short of the investment needed. The Gates Foundation is pledging more for research and development to address the need for new tools as mentioned by Dr Alonso. A big challenge is adequate funding to sustain the implementation of both existing tools and the new ones when they come online. Even in the context of a malaria elimination framework, WHO stresses the need to maintain appropriate levels of intervention with case management, ITNs and other measures regardless of the stage of elimination at which a country or sub-strata of a country is focused.

Twenty years after the formation of RBM and 70 years after the foundation of WHO, the children, families and communities of endemic countries are certainly ready to beat malaria. The question is whether the national and global partners are equally ready.

African Leaders Malaria Alliance Recognizes Country Achievements, Adds NTDs to its Scorecard

The 30th African Union (AU) Heads of State Summit at its headquarters in Addis Ababa, Ethiopia provided an important opportunity to bring the challenges of infectious diseases on the continent to the forefront. Led by the African Leaders Malaria Alliance (ALMA), two major activities occurred, raising greater awareness and commitment to fighting neglected tropical diseases (NTDs) and recognizing the contributions countries have made in the fight against malaria.

For many years ALMA has maintained Scorecard for Accountability and Action by monitoring country progress on key malaria interventions. It later added key maternal and child health indicators.  At the AU Summit ALMA announced that NTD indicators would be added to the scorecards which are reported by country and in summary.

The scorecard will now “report progress for the 47 NTD-affected countries in sub-Saharan Africa in their strategies to treat and prevent the five most common NTDs: lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma. By adding NTDs to the scorecard, African leaders are making a public commitment to hold themselves accountable for progress on these diseases.”

In the press release Joy Phumaphi, Executive Secretary ofALMA, explained that, “Malaria and NTDs both lay their heaviest burden on the poor, rural and marginalised. They also share solutions, from vector control to community-based treatment. Adding NTDs to our scorecard will help give leaders the information they need to end the cycle of poverty and reach everyone, everywhere with needed health care.” This will be an opportunity to demonstrate, for example, that, “In 2016, 40 million more people were reached with preventive treatment for at least one NTD than the year before.”

The combination is based on the logic that NTDs and malaria are both diseases of poverty. Malaria and several NTDs are also vector-borne. Also community platforms are a foundation for delivering needed drugs and supplies to tackle these diseases. Ultimately the decision shows that Heads of State are holding themselves accountable for progress in eliminating these diseases.

At a malaria-focused side meeting of the AU Summit Dr. Kebede Worku (Ethiopia’s State Minister of Health) shared that his government has been mobilizing large amount of resources to the fight against malaria which has led to the shrinking of morbidity and mortality since 2005. He also stressed that Africans should be committed to eliminate malaria by the year 2030. “Failing to do so is to repeat the great failure of 1960s faced at the global malaria fighting.”

The highlight for the malaria community at the Summit was the recognition of six countries that have made exemplary progress in the past year. The 6 countries that are leading the way to a Malaria-Free Africa by 2030 are Algeria, Comoros, Madagascar, the Gambia, Senegal, and Zimbabwe, recognized by ALMA for their sharp decline in malaria cases. Madagascar, the Gambia, Senegal and Zimbabwe Reduced malaria cases by more than 20 percent from 2015 to 2016. Algeria and Comoros are on track to achieve a more than 40 percent drop in cases by 2020.

H.E . Dr. Barnabas Sibusiso Dlamini, the Prime Minister of the Kingdom of Swaziland, whose King and Head of State is the current chair of ALMA, warned all endemic countries that, “When we take our eyes off malaria, the cost for our countries is huge. Yet if we increase our efforts to control and eventually eliminate malaria, the yield we get from it is tremendous. It is time that we dig deep into our pockets and provide malaria programmes with the needed resources.”

Mentioning the need for resources raises a flag that calls on us to be a bit more circumspect about progress. IRINNews notes that this is a critical time in the fight against malaria, when threatened funding cuts could tip the balance in an already precarious struggle. IRIN takes the example of Zambia to raise caution. They report that the results of malaria control and the government efforts have been uneven. While parasite prevalence among small children is down almost by half in some areas, many parts of the country have seen increases in prevalence

IRIN concludes that, “For now, the biggest challenge for Zambia will be closing the gap in its malaria elimination strategy, which will cost around $160 million a year and is currently only about 50 percent funded – two thirds from international donors and one third from the Zambian government. Privately, international donors say the government must spend more money on its malaria programme if it is to succeed.” Cross-border transmission adds to the problem.

Internal strife is another challenge to malaria success. “The recent nurses’ strike which lasted for five months may have cost Kenya a continental award in reducing the prevalence of malaria during the 30th African Union Summit in Ethiopia on Sunday.” John Muchangi in the Star also noted that, “However, Kenya lost momentum last year and a major malaria outbreak during the prolonged nurses’ strike killed more than 30 people within two weeks in October.”

Finally changes in epidemiology threaten efforts to eliminate malaria in Africa. Nkumana, et al. explain that, “Although the burden of Plasmodium falciparum malaria is gradually declining in many parts of Africa, it is characterized by spatial and temporal variability that presents new and evolving challenges for malaria control programs. Reductions in the malaria burden need to be sustained in the face of changing epidemiology whilst simultaneously tackling significant pockets of sustained or increasing transmission. Many countries like Zambia thus face both a financial and an epidemiological challenge.

Fortunately ALMA is equipped with the monitoring and advocacy tools to ensure that its members recognize and respond to such challenges. The Scorecards will keep the fight against the infectious diseases of poverty on track.

Malaria Day 17 Years Later: Documenting and Investing to End Malaria

The first time the global community observed a day devoted to tackling the problem of malaria was April 25th 2001. This was agreed upon at the African Summit on Roll Back Malaria held in Abuja, Nigeria in 2000. The first seven annual observances were titled “Africa Malaria Day,” and recognized that the largest global burden of the disease affects people on the African continent. As thoughts moved toward elimination, the importance of addressing all endemic communities resulted in the first “World Malaria Day” in 2008.

Thus on April 25th 2017 we are observing the 17th Malaria Day overall and the 10th anniversary of World Malaria Day. This observance has been complimented over the years with a malaria day for the Southern African Development Community and for countries in the Americas.

Each year Malaria Day has had a theme or themes to help focus education and advocacy. Regardless of the theme, the special day has been a time to mark progress and rally partners from the global to community level to continue the fight against the disease. The list below shows some of the issues/themes raised on the past Malaria Days. As noted, in some years advocacy efforts dealt with more than one key idea, though all are not presented.

  • 2001 – Africa Malaria Day 2001: The First Africa Malaria Day; Malaria – A Crisis With Solutions; A Malaria Free-World
  • 2002 – Mobilizing Communities to Roll Back Malaria
  • 2003 – Insecticide Treated Nets and effective malaria treatment for pregnant
  • women and young children
  • 2004 – A Malaria-Free Future: Children for Children to Roll Back Malaria
  • 2005 – Unite against malaria: Together we can beat malaria
  • 2006 – Get Your ACT Together: Universal Access to Effective Malaria Treatment is a Human Right
  • 2007 – Leadership and Partnership for Results
  • 2008 – Malaria, A Disease without Borders
  • 2009 – Counting Malaria Out
  • 2010 – Counting Malaria Out; (and in the Africa Region) Communities engage to conquer malaria!
  • 2011 – Achieving Progress and Impact
  • 2012 – Sustain Gains. Save Lives. Invest in Malaria
  • 2013-15 – Invest in the Future: Defeat Malaria
  • 2016-17 – End Malaria for Good

In sum these themes emphasize the importance of access to malaria interventions, documenting that access, using the data to stimulate more investment ultimately leading to an end (elimination) of malaria. The most recent World Malaria Report (2016) provides several important examples of the progress so far.

  • Households with least one ITN increased to 79% in 2015
  • 53% of the population at risk slept under an ITN in 2015 in Africa increasing from 30% in 2010
  • The proportion of suspected malaria cases receiving a parasitological test in the public sector increased from 40% in the WHO African Region in 2010 to 76% in 2015
  • In 2015, 31% of eligible pregnant women received three or more doses of intermittent preventive treatment in pregnancy (IPTp) among 20 countries with sufficient data, a major increase from 6% in 2010

In addition to noting progress, the report also points out gaps in appropriate care seeking for malaria, attendance at antenatal care clinics, and adequate numbers of nets for a household. As implied in the IPTp data, there is the additional problem of obtaining timely and accurate date to document progress and/or gaps. Looking at the Malaria Day themes around investing, we know that unless one can show investors results, it will be difficult to “End Malaria for Good.”

Country Updates on Global Call to Action to Increase Coverage of Intermittent Preventive Treatment in Pregnancy

Symposium 87 at the 65th Annual Meeting of the American Society of Tropical Medicine and Hygiene focused on the Global Call to Action to Increase Coverage of Intermittent Preventive Treatment in Pregnancy: Progress and Lessons Learned. The original Global Call was initiated at a previous ASTMH meeting. Elaine Roman of Jhpiego chaired the session. Panelists included Julie Gutman of the US CDC,  Frank Chacky of the NMCP in Tanzania, Yacouba Savadogo of the NMCP in Burkina Faso and Fannie Kachale of the Reproductive Health Directorate in the Malawi MOH.

symp-tanzania-1The symposium speakers reviewed country progress in sub-Saharan Africa (SSA) in increasing intermittent preventative treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). They described how Ministries of Health and donors and partners are working to increase IPTp-SP coverage to address malaria in pregnancy (MiP).

Following the release of the World Health Organization’s (WHO) 2012 updated policy on IPTp-SP, a number of global stakeholders came together through the Roll Back Malaria-Malaria in Pregnancy Working Group, to elaborate the Global Call to Action: To Increase National Coverage with IPTp of MiP for Immediate Impact. The Call to Action calls upon countries and partners to immediately scale up IPTp-SP to improve health outcomes for mothers and their newborns. Scaling up IPTp-SP across most countries in sub-Saharan Africa remains a critical weapon to prevent the devastating consequences of MiP.

symp-ipt-update-malawi

IPTp3+ has been started in Malawi following WHO recommendations

However, the low proportion of eligible pregnant women receiving at least one dose of IPTp-SP (52%) and IPTp3-SP (17%) in 2014 is unacceptable. Despite growing parasite resistance to SP in some areas, IPTp-SP remains Tuesday a highly cost-effective, life-saving strategy to prevent the adverse effects of MiP in the vast majority of SSA.

Completion of the recommended three or more doses of IPTp-SP decreases the incidence of low birthweight (LBW) by 27%, severe maternal anemia by 40% and neonatal mortality by 38%. This symposium will feature presentations from WHO and the President’s Malaria Initiative on how they are prioritizing support to scale up MiP interventions including IPTp-SP across SSA.

Panelists from Burkina Faso, Malawi and Tanzania discussed how they were able to dramatically scale up IPTp-SP through a health systems approach that addresses MiP from community to district to national level.

symp-ipt-burkinaIn Burkina Faso, IPTp2-SP increased from 54.8% in 2013 to 82.3% nationally in 2015 and IPTp3-SP increased from 13.5% in 2014 to 41.2% nationally in 2015. Moving ahead Burkina Faso will Improve SP supply chain management, Pilot an IPTp distribution at the community level in three districts, Provide job aids throughout ANC clinics, and Provide support to district team for data review and analysis.

In Malawi, in targeted project sites across 15 districts, IPTp1 uptake increased from 44% in 2012 to 87% in 2015, while IPT2 increased from 16% to 61% over the same time period. Lessons learned from scale up include –

  • Consistent availability of SP for IPTp is critical to increasing coverage
  • A clear policy put in place to guide IPTp implementation is crucialsymp-building-blocks-malawi
  • A strong partnership between the Reproductive Health Directorate and National Malaria Control Programme is necessary
  • Intensification of information, education, and communication is crucial to increase uptake of ANC services
  • Strong collaboration, planning, and coordination between partners and other stakeholders improve ANC attendance
  • Antenatal clinics offers enormous opportunities for delivering the malaria prevention package, such as IPTp and insecticide-treated nets, to pregnant women

symp-ipt-tanzaniaIn Tanzania, IPTp2-SP increased from 34% in 2014 to 57% in 2015 and IPTp4-SP was reported at 22% in 225 facilities across 16 districts, in 2015. Program learning in Tanzania identified that consistent availability of commodities at facility level can complement Government’s and partners’ efforts to ensure provision of quality MiP services. Despite increased number of trained health care workers and regular supportive supervision and mentoring, increasing uptake of IPTp will continue to be a challenge unless malaria commodities such as mRDT and SP are available at health facilities. Redistribution of commodities among facilities could be crucial balancing the stock.

symp-tanzania-by-regionMoving forward Tanzania plans to use alternative funding to procure malaria commodities at health facility (e.g., Community Health Fund, National Health Insurance Fund, basket fund). Other efforts will include conducting onsite mentorship and coaching, data collection and interpretation, selecting sentinel sites for collecting IPTp3, working with Ministry of Health HMIS to revise HMIS tools when opportunity arises, and training Community Health Workers (CHWs) on maternal, neonatal and child health interventions including early booking of ANC services.

These three country examples demonstrate that progress is challenging but possible. The call to action for increased IPTp access and use is stronger today.

Malaria Day in The Americas Forum

In commemoration of Malaria Day in the Americas 2016

The Pan American Health Organization, The UN Foundation, The Milken Institute School of Public Health at The George Washington University, and Center for Communication Programs at The Johns Hopkins Bloomberg School of Public Health

Cordially invite you to attend the

“End Malaria for Good” Forum

Featuring videos, presentations and discussions on

The work of the ‘Malaria Champions of the Americas 2016’

malariaevite-2016-americasWHEN: Thursday, November 3, 2016, TIME: 1:00 p.m. to 3:30 p.m.

WHERE: Room B, PAHO Headquarters, 525 23rd Street NW, Washington, DC—20037

RSVP: Please fill out the form at https://goo.gl/0oaPzX

Light refreshments will be served

Health systems strengthening: Advocacy facilitates availability of sulfadoxine-pyrimethamine for prevention of malaria in pregnancy in Kenya

Colleagues[1] from Jhpiego’s Kenya office and the Ministry of Health are presenting a poster at the 64th ASTMH Annual Meeting in Philadelphia at noon on Tuesday 27th October 2015. Please stop by Poster LB-5225 and discuss the results as presented in the Abstract below.

Kenya PfIn malaria endemic areas, infection with malaria during pregnancy is often associated with poor pregnancy outcomes. Although effective intervention measures are available including use of sulfadoxine pyrimethamine (SP) for intermittent preventive treatment of malaria in pregnancy (IPTp) coverage rates have remained low.

In Kenya, IPTp2 is at 38% in malaria endemic counties some of the key factors influencing IPTp uptake being SP stock-outs. The national government has been supplying SP but on devolution of health services to county governments it became the responsibility of the counties. There are many competing financial demands at county level and SP stock out is frequent.

ANC KenyaIn February 2015 the national government disseminated a memo to county governments advising them to procure SP to avert the worsening SP stock out situation. After issuance of the memo, USAID’S flagship Maternal and Child Survival Program (MCSP) held discussions with the County Directors of Health (CDHs) and shared the quantification formula for SP requirement for the respective counties.

MCSP advocated for procurement of SP especially during the peak malaria transmission period May-August 2015. The CDHs on realizing the cost was not high made immediate arrangements for procurement of SP.

Bungoma County procured enough SP tablets to cover the peak malaria transmission season and distributed them to the health facilities. Results on analysed ANC data from facilities showed that the number of pregnant women accessing IPTp had reduced from 7,845 in October 2014 to 3,856 in February 2015.

IPTp coverageOne month after procurement and distribution of SP, the number accessing SP increased from 3,856 to 6,769. To improve pregnancy outcomes in malaria endemic areas it is vital to reduce the effects of malaria during pregnancy. Use of IPTp-SP during pregnancy has been shown to improve pregnancy outcomes however, coverage rates of the intervention have remained below the national target due to several influencing factors like the SP stock-out situation experienced in Kenya.

The use of advocacy with relevant authorities in Bungoma County leading to improvement in the SP stock out situation is considered a best practice in ensuring health commodity security and is being replicated in other malaria endemic counties.

[1] Augustine M. Ngindu, Gathari G. Ndirangu, Wekesa Kubasu, Isaac M. Malonza

 

World Malaria Day 2015 Blog Postings Help #DefeatMalaria

wmd2015logoA special World Malaria Day 2015 Blog has been established. So far nine postings are available at http://www.worldmalariaday.org/blog. Please read and share with colleagues.

1. “Investing in integrated health services to defeat malaria”BY ELAINE ROMAN, MCSP Malaria Team Lead.

2. “Fake antimalarials: how big is the problem?”

BY DÉBORA MIRANDA, Technical Communications Officer, ACT Consortium (UK).

3. “Why antimalarial medicines matter”WMD15_7_Facebook_Final

BY PROFESSOR PAUL NEWTON AND ANDREA STEWART, Worldwide Antimalarial Resistance Network and Laos Oxford University Mahosot Hospital Wellcome Trust Research Unit.

4. “Malaria as an entry point for addressing other conditions”

BY HELEN COUNIHAN, Senior Public Health Specialist, Community Health Systems.

5. “Bridging the Care-Seeking Gap with ProAct”

BY MATT McLAUGHLIN, Program Manager of Peace Corps Stomping Out Malaria in Africa initiative.

WMD15_6a_Facebook_Final6. “Defeating Malaria in Pregnancy”

BY CATHERINE NDUNGU, ELAINE ROMAN AND AUGUSTINE NGINDU, Jhpiego.

7. “Intermittent Preventive Treatment, a Key Tool to Prevent and Control Malaria in Pregnancy”

BY CLARA MENÉNDEZ, Director of ISGlobal’s Maternal Child and Reproductive Health Initiative.

8. “Widespread artemisinin resistance could wipe out a decade of malaria investment”

BY TIM FRANCE, Asia Pacific Leaders Malaria Alliance.

9. “The long walk to a malaria-free world”

BY DAVID REDDY, CEO Medicines for Malaria Venture.

Supporting one Another: Female Nurses in Senegal helping Women have Malaria-free Pregnancies

Yacine Djibo, Founder & President of Speak Up Africa is helping focus International Women’s Day (March 8th) on efforts to protect women from malaria in Senegal. She is highlighting the ZeroPalucommitments of 8 strong and beautiful women, in Senegal, that are dedicated to eliminating malaria in their country. These commitments are part of an inclusive mass communication campaign that aims to launch a national movement in favor of malaria elimination in Senegal: the “Zero Malaria! Count Me In” campaign

International Women’s Day, represents an opportunity to celebrate the achievements of women all around the world. This year’s theme is “Empowering Women – Empowering Humanity: Picture it” envisions a world where each woman and girl can exercise her choices, such as participating in politics, getting an education or fighting malaria. Below is the eighth and final feature on women fighting malaria in Senegal ……

Nurse, Health Center, Guédiawaye District, Senegal

Nurse, Health Center, Guédiawaye District, Senegal

Nurses at the health center in Senegal’s Guédiawaye district bring their expertise to tirelessly provide essential malaria services to all community members. Of particular importance are pregnant women, a vulnerable group which must have access to prevention and treatment tools to ensure healthy pregnancies and healthy newborns.

Reducing the rate of infection to protect mothers and children is key, and remains one of the most pressing health issues facing the malaria community today. Pregnant women are at a higher risk for malaria as pregnancy reduces a woman’s immunity. Without the acquisition and use of insecticide treated mosquito nets and intermittent preventive treatment in pregnancy (IPTp), there is an increased risk of women (particularly those in their first and second pregnancies) contracting malaria, which can result in premature birth, low birth weight, and stillbirth.

iwd_squareEach nurse’s job is twofold, to ensure women have the proper information and tools to prevent and treat malaria cases, and to ensure clear communication with her health post for what is needed in the community. Nurses are essential and their work is applauded on International Women’s day, as we recognize amazing examples of women supporting their fellow women to ensure health needs are met.

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Headquartered in Dakar, Senegal, Speak Up Africa is a creative health communications and advocacy organization dedicated to catalyzing African leadership, enabling policy change, securing resources and inspiring individual action for the most pressing issue affecting Africa’s future: child health.