Equipping FBOs for Malaria Programming activities:. Some Technical Facts and Key Organizational/Management Issues Presentation at CCIH Annual Meeting on May 26,2007 Larry Casazza, MD MPH Director, ACAM-African Communities Against Malaria. PURPOSE.
Some Technical Facts and Key Organizational/Management Issues
Presentation at CCIH Annual Meeting on May 26,2007
Larry Casazza, MD MPH
Director, ACAM-African Communities Against Malaria
To mobilize FBOs for their participation and contributions to confront malaria in their host countries in collaboration with other public and private actors committed to reducing the incidence and impact of malaria.
28% of 0-4 yr mortality
57% of 5-14 yr mortality
6% of 14+ mortality
Source: adapted from (Eds) Gilles and Warrell. Essential Malariology, Oxford University Press
The most effective way to prevent malaria is through the selective and safe use ofinsecticides that kill the malaria transmitting mosquito.
There are two options for getting these insecticides into the homes of those most at risk: indoor residual spraying (IRS) and insecticide-treated nets (ITNs).
IRS is best suited for areas of unstable malaria, epidemic prone malaria, in urban settings when local transmission of malaria is well documented, and in refugee camps.
In each of these settings IRS has important advantages: it has rapid and reliable short-term impact and can be targeted to communities at highest risk.
IRS is, however, relatively demanding in terms of the logistics, infrastructure, skills, planning systems and coverage levels.
The consensus is that in endemic Africa (south of the Sahel and north of the Zambezi River) ITNs are the most practical and effective means for protecting the population
ITNs have been shown to be highly deployable in rural Africa using the existing NGOs, commercial sector, community groups and public sector infrastructure.
ITNs provide significant protection to those sleeping under them, and can reduce all cause mortality in children by one-fifth and episodes of malaria by half.
Maintaining supply chains and behavioral promotion activities to keep ITNs widely available, insecticidally-active and effectively used is a challenge
SectorExpanding ITN Coverage Through Market Segmentation
But what about access and sustainability of prevention interventions for those millions at the “Bottom of the Pyramid” not targeted by current program efforts?(4/5
Where are the FBOs and CBOs in the national programs? (They do implement IRS in CHEs.)
Chronic or Recurrent
#6 MALARIA 101 – clinical syndromes
*only use when there are no alternative effective antimalarials
Malaria Treatment Guidelines 2006:
This is because:
New medicines must be highly effective and efficacious in curing malaria infections, and have a long, useful therapeutic life
RDTs reduce ACT use when the fever is not clinically caused by malaria
Expanding parasite-based diagnosis
(roughly 25% reduction)
Equity & Vulnerable Groups
Clinical and ANC Services
Household and Community Demand Creation
Development of new Services
FBOs, CBOs, NGOs
Coupling Technical Expertise With Management & Implementation Capability
Strong implementation expertise
Provide established focal point for technical input
Often lack minimal leadership, management, or administrative capabilities
Governments have no clear model of how to work with NGO’s (and vise versa)
Seven +/Secretariats now under formation
Relationship & Governance
Marketing & Communication
PartnershipCreating A Basic “Toolbox” For Networks To Build Capability
The top–down, or “blueprint” intervention strategy disconnects learning from action