Category Archives: Case Management

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: 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.

Improved Malaria Case Management of Children under Age 5: The Experience of the MCSP Restoration of Health Services Liberia Project

Catherine Gbozee, Birhanu Getahun, Topian Zikeh, Anne Fiedler, and Allyson Nelson of the Maternal and Child Survival Program (Jhpiego and John Snow, Inc.) have presented experiences on improving malaria case management for children in Liberia at the 7th Multilateral Initiative for Malaria Conference in Dakar. Below are their findings.

In malaria-endemic countries, malaria is the second leading cause of mortality for children under the age of 5 years. In Liberia Mortality rate for children under the age of 5 years was 94 per 1,000 in 2013. Malaria accounts for 31% of outpatient mortality for children under the age of 5 years and 51% of all outpatient consultations. Malaria among children under the age of 5 years accounts for 20.5% of all outpatient consultations in Liberia Health services weakened by the epidemic of Ebola virus disease. Over 40% of children under the age of 5 years have tested positive for malaria using malaria rapid diagnostic tests (mRDTs) since 2009 (see Figure 1)

Maternal and Child Survival Program (MCSP) Restoration of Health Services (RHS) Project Objectives for malaria include prevention at facilities, Strengthen infection prevention and control (IPC) practices at 77 health facilities through training, intensive supportive supervision, triage, improvement of waste management, and provision of essential IPC commodities and supplies, Increased utilization of and demand for maternal and child health services—Restore delivery of quality primary health care services through implementation of integrated reproductive, maternal, newborn, child, and adolescent health as part of the Essential Package of Health Services in 77 facilities.

MCSP RHS supported health facilities in three counties

  • Grand Bassa: 30 (91% of health facilities in county)
  • Lofa: 17 (27% of health facilities in county)
  • Nimba: 30 (46% of health facilities in county)
  • Population coverage: 900,000 (20% of total population)

Liberia Malaria Indicator Survey 20164 showed that mRDT was done for only 43% and 44% of children with fever in North Central and South Central regions, respectively. Treatment with artemisinin-based combination therapy (ACT) improved from 43% to 81% from 2013 to 2016. Intervention approaches are outlined at the left.

Scores for all technical areas, including malaria, improved
from baseline to endline (see Figure 2). Median facility scores for adherence to malaria clinical standards improved by 75% between baseline and endline in half of MCSP facilities sampled (see Figures 3 and 4). Percent of malaria cases in children under 5 years of age receiving ACT for malaria in MCSP-supported facilities improved from 76% to 82%, despite sporadic stock-outs of ACT (see Figure 5)

Challenges included Frequent stock-outs of mRDTs and ACT. There were Bad roads and broken bridges challenging for supportive supervision, malaria commodity distribution, and facility accessibility to users.

Lessons Learned included Task-shifting and comprehensive hands-on health workforce improvement approaches are essential for revamping and improving quality care provision in post-disaster settings such as Liberia. Uninterrupted and sustained supplies of mRDTs, ACT, and malaria commodities are key for quality malaria case management.


1. World Health Organization (WHO). 2015. MCEE-WHO methods and data sources for child causes of death 2000–2015. WHO website. Accessed April 2, 2018.

2. Liberia Institute of Statistics and Geo-Information Services (LISGIS), Ministry of Health and Social Welfare Liberia, National AIDS Control Program Liberia, et al. 2014.
Liberia demographic and health survey 2013. Demographic and Health Surveys Program website. Accessed April 2, 2018.

3. Liberia Ministry of Health. Liberia Ministry of Health Annual Report 2015. Monrovia, Liberia: Ministry of Health.

4. National Malaria Control Program, Liberia Institute of Statistics and Geo-Information Services, and The DHS Program. 2017. Liberia Malaria Indicator Survey 2016.
The Demographic and Health Surveys Program website. Accessed April 2, 2018.

This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the Maternal and Child Survival Program and do not necessarily reflect the views of USAID or the United States Government.

Febrile Illness Case Management in Madagascar: Lessons from a Facility Provider Case Scenario Assessment

Rachel Favero, Jean Pierre Rakotovao, Lalanirina Ravony, Reena Sethi, Katherine Wolf, Barbara Rawlins, Eliane Razafimandimby, Andrianandraina Ralaivaomisa, Toky Rakotondrainibe, Mamy Razafimahatratra, Thierry Franchard, Sedera Mioramalala, Joss Razafindrakoto, and Catherine Dentinger of the Maternal and Child Survival Program/Jhpiego, the National Malaria Control Programme and the United States Agency for International Development/Madagascar examine malaria care seeking in Madagascar. Their findings were presented at the 7th Multilateral Initiative for Malaria Conference in Dakar and are shared below.

In 2016, malaria accounted for 5.9% of outpatient visits and 6.7% of all deaths in Madagascar. Care is often delayed and the recommended treatment protocols for management of febrile illness are not systematically applied. Children and adults do not always receive medication for febrile illness and when they do, it is not always the correct medication or dosage, as noted in MEDALI (Mission d’Etude des Déterminants de l’Accès aux Méthodes de Lutte antipaludique et de leur Impact) Quantitative and Qualitative 2014.

Study Goals aimed to Identify gaps, attitudes, and practices that may Prevent timely care seeking for febrile illness (within 24 hours after onset of fever) in the formal health system and Lead to nonadherence to national guidelines for malaria treatment. Key assessment questions included What strategies could be adopted to encourage pregnant women and caregivers of children under age 15 to use the formal health system as their primary resource for treatment of febrile illness? The study also asked What are the reasons that health providers do not systematically apply national malaria treatment guidelines?

Study districts were sampled from eight malaria operational zones. In-depth interviews with the following groups (N = 90). Facility health care providers, both public and private were included as were Community health workers and Caregivers of children under age 15 and pregnant women. Focus group discussions were held with caregivers of children
under the age of 15 years, including pregnant women (N = 16).

A Case scenario was reviewed with facility providers (N = 15). A case scenario is a description of a made-up situation involving a decision to be made or a problem to be solved. The case scenario used was febrile illness in children and pregnant women. This scenario allowed the study team to understand provider response. Provider responses to the scenarios are seen below.


From the review of case studies one could see that Facility provider diagnosis and treatment of malaria does not always conform to national protocol. Therefore, Targeted efforts to improve provider knowledge and practice are needed. Effort must be made to Ensure that standards/protocols are available in the health facilities and that providers have received guidance on the standards/protocols. Finally, Supportive supervision should be provided to address gaps in knowledge and practice.

This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the Maternal and Child Survival Program and do not necessarily reflect the views of USAID, PMI, or the United States Government.

Community Health Volunteers Contribute to Improved Malaria Prevention and Management in Kribi, Cameroon

Kodjo Morgah, Eric Tchinda, and Naibei Mbaïbardoum of Jhpiego (a Johns Hopkins University Affiliate) in Cameroon are presenting a poster at the Multilateral Initiative for Malaria Conference in Dakar this week. Their findings, seen below, show how community health volunteers can contribute to improving the quality of malaria control services in Chad and Cameroon.

CHV Lilian Kubeh preparing to administer a rapid diagnostic test. Photo by Karen Kasmauski.

Project objectives focused overall on contributing to the reduction of malaria-related morbidity and mortality in Cameroon and Chad. It also aimed to strengthen community-based interventions through the use of community health volunteers (CHVs) to manage simple cases of malaria and conduct awareness-raising activities. The geographic scope of the project was Kribi District in the south of Cameroon. Thirty-two health facilities are supported by Jhpiego. Kribi District has an estimated population of 134,876.

Reports from the National Malaria Control Program show that malaria is the leading cause of morbidity in Cameroon—an estimated 1,500,000 cases occur each year. In 2016, it was the leading reason for medical consultations (23.6% of all medical consultations) and hospitalizations (46% of all hospitalizations). Among children under 5 years of age, malaria accounted for 41% of all medical consultations and 55% of all hospitalizations. Malaria is also a leading cause of mortality. In 2016, Cameroon had 2,639 deaths caused by malaria—12% of all deaths across all age groups and 28% of all deaths among children under 5 years of age were attributed to malaria.

Project intervention strategies target the four levels of the health system. The CHV intervention was mobilized to support the strategy at the community level as seen in the attached diagram. In 2012 and 2014, 38 CHVs were selected by the community and received training to support areas in the district more than 10 km from a health center. (Note: 10 km was the measurement tool used to determine the geographic scope of each CHV for this project.) An initial donation of medications, data collection tools, and small equipment was made available to CHVs using funding from ExxonMobil Foundation.  An evaluation of the training intervention was conducted by an external consultant in April 2016.

CHV Daniel Ze conducting an individual educational session on IPTp. Photo by Karen Kasmauski.

CHVs conduct outreach activities in their communities—via home visits and community education sessions—to provide health education on malaria transmission and prevention, use of long-lasting insecticidal nets, the importance of intermittent preventive treatment in pregnancy (IPTp), and the importance of promptly seeking medical care for suspected cases of malaria. CHVs also support national health campaigns and health promotion events, including World Malaria Day. In Cameroon, where CHVs are also able to test and treat patients, they administer rapid diagnostic tests (RDTs) and treat cases of uncomplicated malaria.

Motivation of CHVs included ongoing training and technical updates, regular replenishment of materials, CHVs are recognized and respected community leaders, provision of per diem and transport costs, and continued advocacy targeting district officials to provide CHV stipends to ensure sustainability. Attached are details of the supervisory activities that provided continual technical support to the CHVs to ensure that they retain knowledge and skills to carry out their activities and track their data.

Between 2013 and 2016 CHVs in these communities were able to reach nearly 20,000 people with a variety of malaria services as seen in the attached table. The project paid close attention to data quality, which was reviewed with the CHVs on a regular basis, resulting in improved data quality.  CHVs improved the accessibility of malaria prevention and care services for communities living in remote areas. Results from April 2016 external evaluation show these results. Knowledge of malaria prevention is significantly higher in households that did not receive CHV support (p = 0.001). Use of long-lasting insecticide-treated nets is higher in households that benefitted from CHV support (88%) than in households that did not benefit from CHV support (73%) (p = 0.023). There was an increase in the delivery of IPTp2, from 60% in 2012 to 70% in 2016.

In conclusion CHVs have increased their communities’ access to health centers through referrals, health education on malaria prevention, IPTp, and treatment for simple and severe cases of malaria. Regular supervision of CHVs by their supervisors (the health zone managers) is essential to maintaining and strengthening CHV performance and motivation. Continuing advocacy efforts with local authorities is necessary to ensure that CHV activities are sustainable. The project team aims to establish a mechanism to improve documentation of its activities to better measure the impact on indicators at the community, facility, and district levels, and provide evidence for advocacy to sustain these efforts.

Multilateral Initiative for Malaria (MIM) – Jhpiego Presents in Dakar

The 7th Pan African Malaria Conference holds from 15-20 April 2017, Dakar, Senegal. The conference celebrates 20 years since the initial establishment of the Multilateral Initiative on Malaria (MIM) by the Tropical Disease Research Program and partners.

During the conference next week, staff from Jhpiego malaria projects in Burkina Faso, Liberia, Nepal, Madagascar and Cameroon will share oral and poster presentations to highlight their work. Below is a list along with the location numbers.

  • Application d’un Audit de la Qualité des données (DQA) du paludisme dans le District Sanitaire de Kribi, Cameroun, SS-13 Oral
  • Contribution des Agent de Santé Communautaire (ASC) à l’amélioration de la prévention et la prise en charge du paludisme dans le district de Kribi, Cameroun, B-40 Poster
  • MOH’s effort in developing and implementing Quality Assurance plan (QAP) for Global Fund-supported antimalarial drugs: A case study of Nepal in the context of malaria elimination, C-107 Poster
  • Community-Based Health Workers in Burkina Faso: Are they ready to take on a larger role to prevent malaria in pregnancy? D-115 Poster
  • Contribution of Community-Based Health Workers (CBHWs) to Improving Prevention of Malaria in Pregnancy in Burkina Faso: Review of health worker perceptions from the baseline study D-118 Poster
  • Malaria in Pregnancy: The Experience of MCSP in Liberia, D-140 Poster
  • Improved Malaria Case Management of Under-Five Children: The Experience of MCSP-Restoration of Health Liberia project D-141 Poster
  • Experiences and perceptions of care seeking for febrile illness among caregivers, pregnant women and health providers in eight districts of Madagascar D-142 Poster

Abstracts will be shared here on the day of each presentation for those unable to attend MIM. Also check Jhpiego at Exhibit Booth 148.

The Heart of the Malaria Problem

February is Heart Month in some countries. This is a good time to explore how malaria affects the heart and cardiovascular health.

In 1946 Howard Sprague observed that although “malaria is a disease from which no organ or tissue is exempt, this paper is concerned with its influence upon the circulation, and more particularly upon the heart itself.” He then outlined four ways by which this influence happens:

  1. its chronic and recurrent nature
  2. the systemic toxemia of the paroxysm
  3. the profound anemia produced by hemolysis and suppression of hemopoiesis
  4. the occlusion of capillaries and arterioles of the myocardium

Since that time other researchers have elaborated on malaria and the cardiovascular system.

Mishra et al. raise a concern that, “The role of the heart in severe malaria has not received due attention.” They point out the following:

  • hypotension, shock and circulatory collapse observed in severe malaria patients
  • raised cardiac enzymes in complicated malaria
  • compromised microcirculation and lactic acidosis as well as excessive production of pro-inflammatory cytokines
  • Intravascular fluid depletion associated with severe malaria leading to impaired microcirculation … among others

They conclude that “Sudden cardiac deaths can also occur due to cardiac involvement,” but worry that, “It is not feasible to assess the cardiac indices in resource poor settings.”

A study by Ray and co-researchers indicated “involvement of cardiovascular system in severe malaria as evidenced from ECG and echocardiography. The study also revealed that cardiovascular instabilities are common in falciparum malaria, but can also be observed in vivax malaria.” A fatal case of imported malaria where the sole finding revealed at the postmortem evaluation was an acute lymphocytic myocarditis with myocardiolysis was described by Costenaro and colleagues.

In another example, Onwuamaegbu, Henein, and Coats reviewed the potential role of malaria in chronic and severe malaria and the connection to chronic heart failure. They concluded that, “Our review of the literature suggests that there are significant similarities in the cachexia seen in CHF and that of malaria, especially as related to the effects of muscle mass and immunology.” Clinical manifestations in P. falciparum malaria also include reduced cardiac output as was reported in an imported case of malaria by Johanna Herr and co-workers.

Marrelli and Brotto note that, “Sequestration of red blood cells, increased levels of serum creatine kinase and reduced muscle content of essential contractile proteins are some of the potential biomarkers of the damage levels of skeletal and cardiac muscles.” They explain that, “These biomarkers might be useful for prevention of complications and determining the effectiveness of interventions designed to protect cardiac and skeletal muscles from malaria-induced damage.”

Not just malaria as a disease is involved, but also the medicines used to treat it. Ngouesse and colleagues draw attention to antimalarial drugs with cardiovascular side effects. They draw particular attention to the dangers of halofantrine, quinine and quinidine, but also note mild and/or transient effects of other antimalarials.

Guidelines exist for proper and prompt malaria case management, especially protocols for caring for patients with severe malaria. These and the medicines required must be more readily available to front line health staff. And of course is we are more diligent in preventing malaria through long lasting insecticide-treated nets and other measures, our worries about severe malaria and CVD complications will reduce.

Prof Lateef A Salako, 1935-2017, Malaria Champion

Professor Lateef Akinola Salako was an accomplished leader in malaria and health research in Nigeria whose contributions to the University of Ibadan and the Nigeria Institute for Medical Research (among others) advanced the health of the nation, the region and the world. His scientific research and his over 140 scientific publications spanned five decades.

His research not only added to knowledge but also served as a mentoring tool to junior colleagues. Some of his vast areas of interest in malaria ranged from malaria epidemiology, to testing the efficacy of malaria drugs to tackling the problem of malaria in pregnancy. He led a team from three research sites in Nigeria that documented care seeking for children with malaria the acceptability of pre-packaged malaria and pneumonia drugs for children that could be used for community case management. Prof Salako was also involved in malaria vaccine trials and urban malaria studies.

As recent as 2013 Prof Lateef Salako, formerly of NIMR said: “It is true there is a reduction in the rate of malaria cases in the country, but to stamp out this epidemic there is the urgent need for a synergy between researchers, the government, ministries, departments and agencies and involved in malaria control. That will enable coordinated activities that will produce quicker results than what obtains at the moment.”

At least one website has been set up where people can express their condolences.  As one person wrote, “Professor Lateef Salako was an exceptional student, graduating with distinction from medical school; an unforgettable teacher, speaking as a beneficiary of his tutelage; an exemplary scholar, mentoring many others; an accomplished scientist, making indelible contributions to knowledge. May his legacy endure.”

Readers are also welcome to add their own comments here about Prof Salako’s contribution to malaria and tropical health.

Community Based Intervention in Malaria Training in Myanmar

Nu Nu Khin of Jhpiego who is working on the US PMI “Defeat Malaria Project” led by URC shares observations on the workshop being held in Yangon with national and regional/state malaria program staff to plan how to strengthen malaria interventions at the community level. The workshop has adapted Jhpiego’s Community Directed Intervention training package to the local setting.

Yesterday’s opening speech was being hailed as a significant milestone to give Community-Based Intervention (CBI) training teams the knowledge, skills, and attitudes they need to effectively provide quality malaria services and quality malaria information.

This core team is going to train the critical groups of community-level implementers including CBI focal persons and malaria volunteers at the community level.

We embarked this important step yesterday with the collaboration of Johns Hopkins University, Myanmar Ministry of Health and Sports, and World Health Organization Myanmar.

Participants will be developing action plans to apply the community approach to malaria efforts in townships and villages in three high transmission Rakhine State, Kayin State and Tanintharyi Region.

Contribution of the Improving Malaria Care (IMC) Project to Improving Malaria Case Management in Burkina Faso

Malaria case management including diagnosis and treatment is an essential component of malaria control and elimination. Ousmane Badolo, Mathurin Dodo, and Bonkoungou Moumouni of Jhpiego working on the USAID Improving Malaria Care Project in Burkina Faso explained at the 66th Annual Meeting of the American Society of Tropical Medicine and Hygiene how they worked to improve case management by Strengthening the capacity of health care providers. There findings follow:

Malaria kills mostly children under five and pregnant women in Burkina Faso, and is the leading reason for medical consultation and hospitalization. Improving case management is a real challenge in reducing morbidity and mortality. The goal of the National Malaria Control Program (NMCP) was to reduce the morbidity by 75% by end of 2000 and malaria mortality to close to zero by the end of 2015.

The United States Agency for International Development-supported Improving Malaria Care (IMC) project aims to reduce malaria morbidity and mortality. This includes strengthening the capacity of health providers to deliver high quality management- diagnosis and treatment, of malaria cases.

Between 2014 and 2016 IMC and the NMCP revised malaria guidelines, oriented 163 national trainers, trained 1,819 providers at all levels and organized supportive supervision of these staff. As a result correct diagnostic testing of malaria cases increased from 62% to 82%.

The proportion of people with uncomplicated malaria who received artemisinin combination therapy (ACT) increased from 85% to 94%. Strengthening of the data management system facilitated this information to be collected.

Training these providers based on national guidelines and reinforcing their learning through supervision has enabled the NMCP to have a pool of health providers capable of treating the most vulnerable population and helping to reduce malaria mortality level in Burkina Faso.

This training is accompanied by the implementation of formative supervision. Continued supervision and quality data management positions the NMCP to reach and document its goals.

Funding for this effort was provided by the United States President’s Malaria Initiative. This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of the Improving Malaria Care Project and do not necessarily reflect the views of USAID or the United States Government.