The fight against malaria received a boost last week when scientists at the Oxford University developed a cheaper vaccine that is anticipated to offer a two-year protection. This is a game-changer in the fight against malaria, for a disease that mostly kills pregnant women and children under the age of five years.
The Star’s Science Editor John Muchangi recently had an interview with the Executive Director, Malaria Partners Zambia, Martha Lungu to understand the infrastructure, assets and the role of community health workers in Zambia’s efforts in malaria control.
Tell me more about the Programme's of Scale grant awarded to fight malaria in Zambia.
The Partners for a Malaria-Free Zambia program is a collaboration between the Ministry of Health in Zambia, Rotary Clubs and implementing partners. The programme is specifically supported and implemented by Rotary and Rotaract clubs in Zambia, The Rotary Club of Federal Way in Washington, USA, provincial health leadership and Community Health Workers in Zambia, The Zambian National Malaria Elimination Centre, Malaria Partners Zambia and Malaria Partners International, World Vision Zambia and World Vision U.S. The Bill & Melinda Gates Foundation and PATH through the Malaria Control and Elimination Partnership in Africa (MACEPA).
Together, they form Partners for a Malaria-Free Zambia, which in 2021 became the first Rotary member-led program to receive The Rotary Foundation’s $2 million Programs of Scale grant (which is awarded every year to a well-developed, evidence-based program with proven success that is led by Rotary members in collaboration with experienced partner organizations and local communities).
With additional funds of $2 million from both World Vision U.S. and the Bill & Melinda Gates Foundation, this $6 million investment is enabling the Partners for a Malaria-Free Zambia team to carry out a three-year program to recruit, train, and support 2,500 new Community Health Workers to combat malaria among more than 1.2 million Zambians, mostly in hard-to-reach areas.
What are the goals and objectives of the programme ?
Partners for a Malaria-Free Zambia is an ambitious program aimed at training 2,500 Community Health Workers to test, diagnose and treat malaria as well as diarrheal and respiratory diseases right in their own rural communities.
This program will ensure that people in hard to reach areas can receive timely malaria treatment close to home, so the disease does not have time to progress into severe or complicated malaria. It also reduces the burden on rural health clinics so they can focus on other serious diseases.
The Rotary members and partners managing the program work closely with district health centers to implement the program and collect data that supports the Zambia National Malaria Elimination Centre’s countrywide strategy to end malaria and strengthen the overall health system for the long term.
The aim of the program is to see a reduction in malaria cases close to 90% for the 10 highly affected districts in the Central and Muchinga provinces, but that will take time to achieve and underscores the program’s focus on: integrating the Community Health Workers with their local health centers and the national health system; and collecting real-time data that can be used to make informed decisions such as where more malaria testing and treatment supplies may be needed.
Why did Zambia win this grant to support a programme dedicated to solve a health problem ?
Zambia has a high burden rate for malaria and a government committed to eliminating the disease.
More than 80% of the population is at risk of malaria and the National Incident rate is 340 cases per 1000 population and mortality rate is at 8 deaths per 100,000 population.
The people most affected by malaria are pregnant women and children under the age of five years whose immune systems are vulnerable and who are very susceptible to the anaemia caused by the malaria parasite.
The program builds on previous Rotary global grant successes in Zambia using a Community Health Worker model that is locally administered by trusted members of their communities and makes healthcare accessible to more people.
Rotarians from the USA have been working closely with Zambian Rotarians for over 12 years to jointly implement three very successful malaria elimination Global Grants prior to applying for the Programs of Scale grant.
You currently seat in the Zambia’s End Malaria Council. What are the key strategies in malaria elimination in our country Zambia ?
Zambia’s End Malaria Council (EMC) convenes senior-level, multi-sectoral stakeholders to complement Zambia’s National Malaria Elimination Programme. The End Malaria Council is country-led and country-owned, and is focused on three priority areas:
- Action & Accountability – Ensure the national strategic plan is implemented by driving action and holding stakeholders accountable.
- Resource Mobilisation – Pursue traditional and innovative financing to mobilise domestic resources to close the existing funding gap.
- Advocacy – Advocate for malaria elimination to remain high on public and private sector agendas.
Your work greatly includes working with Community Health Volunteers.
The Community Health Workers are our true heroes who are willing to help people and make a difference in their communities. They undergo intensive training and are integrated in the Zambia Health care system and bridge the gap between health centres and rural communities.
Community Health Workers are bringing malaria testing and medicines directly to rural communities, resulting in more cases being quickly diagnosed and treated — and reducing the burden on provincial health centers so they can focus on other health concerns.
They are also observing community members for health conditions such as pneumonia, diarrhea, malnutrition, and other diseases that can be treated, as well as providing information about preventing COVID-19 transmissions and the importance of vaccination.
And recently, the Community Health Workers provided valuable support for a mass door-to-door immunization campaign to vaccinate children against polio, and they support polio education and immunization efforts as part of their ongoing work in communities.
What challenges have you faced in the last one year since the programme began ?
We have had our own share of ups and downs and managed to work around them, but I think the major challenge we faced was the impact of Covid-19.
We had to reduce the number of class attendees to comply with the Covid 19 protocols established by our Ministry of Health and this resulted in having to provide more sessions with fewer students in each session, which stretched our budget.
Despite this challenge however, within six months of the program’s launch and adhering to COVID-19 safety protocols, we still managed to train and deploy more than half of the Community Health Workers within their communities, with the remaining health workers to be trained by July 2022.
They have also helped stem the pandemic by providing information about preventing COVID-19 transmissions and the importance of vaccination.
What next ? How do you intend to sustain the gains made from this project when it comes to an end?
As mentioned, the infrastructure, assets and community health workers dedicated to the Partners for a Malaria-Free Zambia program are sustainable, replicable and invaluable resources that can help prevent and treat other diseases among vulnerable and hard to reach communities.
The Ministry of Health has already integrated the Community Health Workers in their health system and are supporting them with test kits and medication. Their commitment to us is that all CHWs will be integrated into their programs going forward.
Any additional remarks on Ending Malaria in Zambia
Rotary Club members are dedicating countless of volunteer hours and their free time to this program. They have held orientations with more than 200 local faith, traditional, and civic leaders so they’re part of the effort around effective practices. The Rotary team is also conducting public awareness campaigns using radio and community programming.
Rotary and Rotaract members in Zambia’s Central, Muchinga, Copperbelt, Luapula, and Lusaka provinces have invested more than 3,000 hours into supporting the malaria elimination activities thus far — by organizing and facilitating the health worker trainings and community orientations, securing supplies and equipment for the Community Health Workers, and advocating for malaria elimination and Rotary’s other disease prevention efforts.
New clubs in the Central and Muchinga provinces have also formed as a result of public awareness generated through Partners for a Malaria-Free Zambia.
