MCC-WHO-3DF community-based malaria control: progress and challenges
Empowered village health volunteers are making significant contributions towards malaria control, there is no more death attributed to malaria in their respective communities and the villagers appreciated very much their services. These sum up the progress to date of community-based malaria control project in 160 remote hard to reach villages being implemented by the Myanmar Council of Churches (MCC). It is financially supported by Three Diseases Fund (3DF), and with technical and management support by WHO.
The project started in 2004 in 94 hard to reach villages in Chin State, Kachin State and Sagaing Division with support from Global Fund, continued with 3DF “bridge fund”, with technical assistance from VBDC and WHO. In February-March 2008, 66 additional volunteers were included. In each target village, the health committee, village elders and Church leaders selected one volunteer. The volunteers are empowered to implement two key interventions: (1) prevention using insecticide-treated mosquito nets (ITNs) and long lasting insecticidal nets (LLINs), and (2) early diagnosis and appropriate treatment as per the national malaria treatment policy.
During the period from Jan 2007 to Nov 2008, the volunteers attended a total of 28,082 persons with febrile illnesses, examined for malaria 25,401 people, detected 9,858 P. falciparum malaria and 14,461 probable malaria cases. On average per month each volunteer attended 10 febrile cases, examined for malaria 9 persons, detected and treated 4 P. falciparum malaria and 5 probable malaria, mostly during the first 2 - 3 days of illness. The early detection and appropriate treatment with effective drugs prevented the development of severe malaria and deaths. As expected, most malaria cases occurred during the rainy months.
Moreover, in 2008 the volunteers treated with insecticides 32,605 mosquito nets and distributed 5,000 long lasting insecticidal nets. They educated and motivated the people to sleep inside mosquito nets every night.
Aside from strong community ownership, other factors that help sustained the performance of the volunteers are: refresher training, logistic support, supportive supervision, monitoring, annual evaluation and planning meetings and feedback to the target communities. Sustaining the community ownership and the logistics and technical support for the project are continuing challenges.