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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.