1 / 13

Zambia National Malaria Indicator Survey 2008: Summary of results

Zambia National Malaria Indicator Survey 2008: Summary of results. National Malaria Control Centre, Lusaka Zambia http://www.nmcc.org.zm. Collaborations . Ministry of Health National Malaria Control Centre, District and Provincial Health Offices Central Statistics Office PATH MACEPA

yule
Download Presentation

Zambia National Malaria Indicator Survey 2008: Summary of results

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Zambia National Malaria Indicator Survey 2008:Summary of results National Malaria Control Centre, Lusaka Zambia http://www.nmcc.org.zm

  2. Collaborations • Ministry of Health • National Malaria Control Centre, District and Provincial Health Offices • Central Statistics Office • PATH MACEPA • PMI, USAID, CDC • World Bank • WHO • UNICEF • University of Zambia (UNZA) • GFATM • RBM MERG

  3. Progress in malaria control measured in household surveys

  4. Progress on; • Malaria Prevention; ITNs, IRS • Malaria Diagnosis, Treatment and Care • Malaria In Pregnancy; through Intermittent Preventive Therapy (IPTp)

  5. Progress as of 2008 - interventions

  6. Progress since 2006 - interventions

  7. Progress - impact • Malaria incidence – improvements in measuring incidence occurring • Malaria parasitemia prevalence decreased: • National = 54% decrease • Urban: 4.6% to 4.3% = 7% decrease • Rural: 29.0% to 12.4% = 57% decrease • All cause mortality for children under age 5 (U5MR) • 29% decrease comparing the periods ~1998-2002 to 2002-2007 (ZDHS)

  8. How does Zambia NMCP decide where to go next? • With interventions? We know that… • Getting close, but have not hit any population-based targets for ITNs, IRS, IPT2 • ITN – remove bottlenecks in procurement • Catch up, keep up, hang up - quantify the replacement needs nationally • IRS being applied more to urban, less malarious areas, • To date not able to measure impact through HH surveys like MIS • SP supply continuity • Not really measuring prompt effective treatment well nationally • Smaller-scale assessments available • Facility versus household measurement • Due to fever versus ‘true’ malaria measurement • Drug diagnostic quantification, procurement and supply management

  9. How does Zambia NMCP decide where to go next? • With impact? Some issues to consider… • Impact to date is likely a result of applying multiple interventions consistently • In rural areas, mostly a combination ITNs + having an effective drug for facility-based treatment • Impact from ITNs has mostly been measured • Not likely to be able to measure as much of its contribution again as we already have • Easier to measure a change from 22% to 10% than from 10% to 5% (or less) parasitemia • Must wait another ~5 years for U5MR measurement

  10. What should the Zambia NMCP do? • Continued focus on increasing coverage of prevention interventions • Hit a target! especially with ITNs, IRS, IPT • Consider applying IRS to areas with more malaria • IRS targeting during spray campaigns based on incidence (?) • Make treatment and diagnosis more available • Scaling up treatment • What does this mean? Moving into communities? • Home management of malaria • Active case detection • Moving to treating ‘real’ malaria and parasitic infections • Training, training, training • Combination of interventions • At least 2 simulatenously

  11. What should the Zambia NMCP do? • Measurable impactgoing forward • Another MIS will only be useful if additional measures to reduce parasitemic infections are undertaken • And even then, MIS will only be useful down to ~5% level of parasite prevalence • Countries/areas below ~5% level should transition to surveillance and case reporting • The majority of Zambian population (in urban areas) already needs this • Development of a more robust surveillance system for malaria incidence monitoring and foci detection

  12. Important points • Households surveys are critical to measure progress against national/local coverage and impact targets, especially during scale up and maintenance phase of malaria control • Quality surveys attempt to strengthen design and measurement issues to maximize inference and validity • Luckily, many procedures and methods have been standardized to help simplify the process • Zambia NMCP has many tools/equipment available to help • Remarkable progress has been made in Zambia and has been documented in MISs in 2006 and 2008

  13. References • The MIS 2006 and 2008 reports and lessons learned are available on the National Malaria Control Centre website • http://www.nmcc.org.zm • RBM Monitoring and Evaluation Reference Group website • http://www.rollbackmalaria.org/merg

More Related