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Malaria Prevention & Treatment

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Malaria remains one of Uganda’s biggest public health problems. PACE has for the last five years, worked with the Ministry of Health (MoH) to reduce the incidence of malaria in Uganda through the distribution of long lasting insecticide treated nets as well as integrated community case management of malaria (iCCM).

Current Malaria Project

Global Fund Malaria-NFM3

PACE as a sub-recipient of TASO is implementing the Global Fund Malaria project-NFM2 in 19 districts. The project aims to reduce childhood morbidity and mortality by providing case management for malaria, diarrhoea and pneumonia among children under 5 years in Uganda. Read More

Pre-Distribution Monitoring of LLIN Activities

PACE with funding from Against Malaria Foundation (AMF) implemented the Pre-Distribution Monitoring (Pre-DMs) of the 2020 LLIN mass campaign. Uganda conducted its third Universal Coverage Campaign (UCC) for the LLINs distribution in 2020 with an aim of increasing access and ownership of nets in communities across the country. Use of long-lasting insecticidal nets (LLINs) is recommended as the primary strategy for prevention of malaria in Uganda (MoH , 2020). In Uganda, malaria is the leading cause of mortality and morbidity and accounts for over 30% of outpatient visits and 20% of hospital admissions. To counter these deaths, the Government of Uganda (GoU) has deliberately intensified Malaria prevention interventions including distribution of LLINs that have resulted in a significant reduction of malaria prevalence from 19% in 2014 to 9.2% (MoH, 2019). Read More

Post Distribution Monitoring of Long Lasting Insecticide Nets

Following the 2017/2018 LLINs Universal Coverage Campaign (UCC), a Post Distribution Monitoring Activity funded by Against Malaria Foundation and implemented by Malaria Consortium as lead agent with PACE Uganda and Church of Uganda (CoU) as Sub Recipients was conducted. This was in partnership with Ministry of Health through the National Malaria Control Programme (NMCP). Against Malaria Foundation (AMF) funded the purchase of 12.7million LLINs which were some of the nets distributed through the campaign. This was the second Universal Coverage Campaign implemented in Uganda after the 2013/2014 campaign. Following this campaign, recommendations were made to improve the follow-up activities, and particularly the monitoring of net condition, ownership, and use among the households that benefitted from the campaign. This was done for a period of 30 months following the 2016/2017 campaign. Read More

Past Malaria Project

Global Fund Malaria -NMF2

Global Fund Malaria

Background:

PACE as a sub-recipient of TASO is implementing the Global Fund Malaria project in 13 districts. The project aims to reduce childhood morbidity and mortality by providing case management for malaria, diarrhoea and pneumonia among children under 5 years in Uganda. The Uganda annual Health Sector Performance Report 2018 revealed malaria and pneumonia as the leading causes of under 5-year-old admissions. Malaria accounted for 32%, followed by pneumonia at 8.5% and respiratory infections at 5.4% of all admissions. In 2018, there were an estimated 405 000 deaths from malaria globally, compared with 416,000 estimated deaths in 2017, and 585 000 in 2010. The Uganda Demographic Health survey reported that the prevalence of diarrhoea among children under 5 years was 20%.

Project Coverage: ICCM interventions were in Mpigi, Wakiso, Mubende, Kyotera, Masaka, Rakai, Gomba, Kalungu, Bukomansimbi, and Kampala.

Building capacity of private health facilities in reporting and management of malaria: Mpigi, Wakiso, Mubende, Mityana, Kyotera, Masaka, Rakai, Gomba, Kalungu, Bukomansimbi, Mukono and Kampala.

The project contributed to the 2015-2020 malaria reduction strategic plan goals

  • Reduce annual malaria deaths from 29 per 100,000 in 2013 to near zero;
  • Reduce malaria morbidity to 30 cases per 1000 population (80% reduction from 2013 levels); and

Reduce the malaria parasite prevalence to less than 7% (>85% reduction from the 2010 levels).

Project Objectives

  • Achieve and sustain at least 90% of malaria cases in the public and private sectors and community level receive prompt treatment according to national guidelines
  • All health facilities and District Health offices report routinely and timely on malaria programme activities
  • At least 85% of the population practices correct malaria prevention and management measures

Target group: Children under 5 years, households with children under 5 years, health workers in public and private health facilities

Strategies:

Integrated community case management for children under 5 years; Behavioural change communication interventions like home visits and community dialogues by the Village Health Teams (VHTs); Resilient systems strengthening through Capacity building of public and public health workers, and Support Supervision of health facilities.

Project Achievements

  • 5,606 VHTs have had their capacity built in integrated community case management of malaria, diarrhoea and pneumonia through refresher trainings, support supervision and quarterly review meetings. By the end of the project, the VHTs had seen 488,816 cases of children under 5 with a fever, tested 464,364 (95%) using a Rapid Diagnostic Test, 334,483 (74%) were found to be positive for malaria of which they treated 306,536 (92%) with  first line malarial ACTs.
  • With the support of ICCM health facility supervisors, the VHTs have visited 152,094 homes and sensitized them on proper mosquito net usage, early treatment seeking behaviour, adherence to treatment. With the VHT parish coordinator and health worker, on a quarterly basis, VHTs visited 10 homes that had frequent episodes of malaria, diarrhoea, pneumonia which they educated them about better preventive practices and health seeking behaviour.
  • By September 2020, 514 Health workers from the 245 public sector health facilities were oriented on the revised implementation guidelines of Integrated Community case management. With these trainings, the health workers ably provided technical assistance to the VHTs while at their homes or during the quarterly VHT review meetings.
  • 312 Health workers in the private health sector were equipped with knowledge and skills in integrated management of malaria and 374 health workers from the same private facilities received training to effectively carry out routine health facility reporting on a weekly, monthly and quarterly basis.
  • Through the targeted support supervision visits conducted by the District Health Management Teams for the 245 health centres in the 9 ICCM supported districts, ICCM reporting improved from 33% by March 2019 to 94% by October 2020. The improved reporting was also enabled by the timely replenishment of reporting tools and continuous mentorships conducted for the VHTs and their health work supervisors.

Distribution of Long lasting Insecticide treated nets (LLINs)

In 2015, PACE, in partnership with MoH, The AIDS Support Organization (TASO) and with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, distributed over 340,000 long-lasting insecticide-treated nets (LLINs) to pregnant women. This was done during antenatal care visits in public and private not for profit health facilities. PACE conducted community social mobilization of pregnant women and their families and training of health workers on malaria case management, use of rapid diagnostic tests and LLINs in 31 districts in the Northern, Eastern and Central regions.

In addition, PACE trained VHTs to improve their knowledge and ability to communicate with their communities on malaria, TB and HIV/AIDS. It also supported awareness activities within communities and schools to ensure that the final beneficiaries of these treated mosquito nets know how to use them and repair them to last longer.

These awareness activities were also geared towards increasing knowledge on prevention and treatment of malaria, TB and HIV/AIDS amongst these target populations

iCCM Project under the Global Fund

With funding from the Global Fund, PACE implemented Integrated Community Case Management of Malaria (iCCM) in 17 districts mainly in Northern Uganda. Under this project, PACE  supported the districts to train Village Health Teams (VHTs) trainers, as well as Village Health Teams VHTs in community case management of malaria.

The VHTs  conducted  household visits in their catchment area, reaching each household with information on how to prevent malaria, and protocols should one present with signs and symptoms of malaria. This project ran through 2017.

iCCM to treat malaria, pneumonia and diarrhoea

With funding from UKAID, PACE continued the implementation of iCCM in the Acholi sub-region (Gulu Amuru Kitgum and Pader). In 2015, PACE worked to improve communities’ access and uptake of low cost quality maternal and child health services and commodities, especially for children under 5 years at private health facilities.

A total of selected 20 eligible private clinics and 140 village drug shops were a part of this project. 123 private sector providers were trained in the provision of correct diarrhoea, malaria & pneumonia treatment.

To strengthen the supply chain, PACE, in 2015, increased stocking levels of ACTm treatment, ORS, zinc and amoxicillin within partner clinics which originally did not stock adequately to over 85 percent. As part of this intervention, owners of drug shops and private clinics were equipped with basic skills of supply chain management. This led to elimination of stock outs of essential medicines and supplies.

Community awareness on the prevalence and impact of malaria and diarrhoea diseases was enhanced in meetings held with opinion leaders, local council leaders and elders. In addition, PACE supported health days and outreaches leading to improved case management of malaria, pneumonia and diarrhoea.

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