The Alliance for Malaria Prevention Toolkit now available

The Alliance for Malaria Prevention is a partnership comprised of over 40 partners, including government agencies, private sector businesses, public sector organizations, faith-based organizations, and humanitarian organizations. Each of these partners provides an invaluable contribution to the partnership in supporting countries reach the RBM 2010 targets through increased LLIN ownership and use. The alliance has recently released its second edition of toolkit for developing integrated campaigns to encourage the distribution and use of long lasting insecticide-treated nets and be downloaded from here. The first edition of the toolkit is also available here.

Malaria on Bioko Island–Spanish

This video presents the training program in malaria control that was recently completed by a group of eight young professionals from the Ministry of Health and Social Welfare (MOHSW) of Equatorial Guinea.  This program was part of the capacity-building initiative implemented by Medical Care Development International, through its Bioko Island Malaria Control Project (BIMCP), that seeks to gradually enable the MOHSW to manage a full range of malaria control interventions.  It was made possible with the financial support of Marathon Oil Corporation and its partners the Ministry of Mines, Industry and Energy; Noble Energy; Sonagas; and Atlantic Methanol.   The training program took place at the National Institute of Public Health in Mexico, Cayetano Heredia University in Peru, and the School for International Training in Vermont. The trainees have returned to Equatorial Guinea and are now receiving in-service training at the BIMCP from a team of expatriate malaria control experts.  A plan is being developed to gradually transfer technical and managerial responsibility for the project to the Equatoguinean trainees.

Below is the Spanish version with English subs

Training of Equato-Guinean students at the Universidad Peruana Cayetano Heredia

This initiative was to strengthen the National Malaria Control of Equatorial Guinea, supported by the public private partnership between the Marathon Oil Company, the Government of Equatorial Guinea, and implemented by Medical Care Development International.

After six months of training in malaria control, students from Equatorial Guinea have successfully completed the "International Diploma in Malaria Control", held at the Universidad Peruana Cayetano Heredia (UPCH) between the months of February to June 2011; Tuesday June 6^th was their graduation day.

In the closing ceremony attended by Dr. Fabiola Leon-Velarde, Dean of the UPCH and Foundation President Cayetano Heredia; Dr. Patricia Garcia, Dean of the Faculty of Public Health at the university; Dr. Alejandro Llanos, Training Program Coordinator; Dr. Gloria Nseng, Director of the National Malaria Control of Equatorial Guinea; Jenny Henderson, National Coordinator of the Strategy for Malaria Control of the Peruvian Ministry of Health; Dr. Pablo Aguilar, the representative of Medical Care Development International (MCDI); Guillermo Gonzales, the representative of PAHO / WHO and NAMRUD; and Dr. Jaime Chang, the representative of USAID.

The International Diploma is part of the activities of the Malaria Control Project on the island of Bioko, within the capacity building component, which began in 2003 as part of the response of the Equato-Guinean Ministry of Health and Welfare to the high morbidity and mortality caused by malaria. This project is funded by the Government of Equatorial Guinea, Marathon Oil Company and its partners, comprised of a corporate social volunteer initiative and public private partnership, which is implemented with the technical support of the North American NGO Medical Care Development International (MCDI), which also implement projects in over 20 countries in Africa, 17 of them funded by PMI-USAID under the IMaD project, an initiative to strengthen malaria diagnostics. In addition, IMaD is a principal recipient of the Global Fund and other funding institutions.

After obtaining good results with 35% reduction of malaria morbidity in children under 5 years old between 2003 and 2008 and becoming the first country in sub-Saharan Africa in achieving the Millennium Development Goals, as a part of institutional strengthening, the Malaria Control Program developed a process of selection, recruitment and training of eight professionals in a transparent manner starting from the creation of the National Human Resources Committee, which held a session of a total of 129 candidates in 2010. Upon returning to Equatorial Guinea, the eight students joined the National Malaria Control Program and Malaria Control Project on the island of Bioko to assist in strengthening the operations of a program of high strategic importance due to the fact that malaria remains the leading cause of death to the poorest populations in the country. The students will participate in the next phase of training, part of the Transition Plan, in which MCDI Technical Officers will continue with on-site training of the project and program operations, a process that will include a robust monitoring and supervision to ensure the completion of all the indicators. It is anticipated that once students reach the desired level, MCDI expatriate staff will leave the project and the national staff will assume their roles.

This training began in September 2010 at the National Public Health Institute of Mexico where the students received lessons on basic malaria concepts. The following stage was held in the U.S. at the School for International Training in Vermont, where students were trained in monitoring and evaluation of malaria and took English as a second language courses. In addition, they had the opportunity to meet representatives of Congress to discuss global health issues.

The third stage took place in the city of Lima, led by the Foundation Cayetano Heredia. The personalized training sessions provided the students with the opportunity to thoroughly analyze key thematic topics. After training in Lima, the students participated in a practical training in the city of Iquitos in the Loreto region. The students were able to observe first-hand the inner workings of the management, implementation, monitoring and evaluation of a malaria control strategy at the regional, district and local levels. As part of the final requirement to complete the academic program, students conducted a situation analysis of institutional and strategic planning of the malaria control strategy in Iquitos. The students identified key problems within the areas of human resources, case management and community participation that needed to be improved. The students formulated an intervention proposal, based on the situational analysis, for the Regional Bureau of Health in Iquitos, which was presented at graduation ceremony to a panel attended by the Director of DIRESA Loreto, Dr. Hugo Rodriguez.

This is a successful effort of institutional strengthening of triangular cooperation of South-North-South, in the framework of the Global Health Initiative, supported by a public-private partnership, where experiences and knowledge were exchanged between Africa and America.

Models of cervical cancer prevention

This panel explores various studies and interventions to explore and address the burden of cervical cancer from the community-based to the national level. Presentations include: an integrated Cervical Cancer Prevention and Control program in Mozambique; a study assessing the feasibility of developing effective cervical cancer prevention programs for women in remote coffee-farming communities by improving access to services through community-based outreach and facilitation, and the development of Single Visit Approach (SVA) services in local clinics; a feasibility study of the integration of cervical cancer screening consultations into the practice of primary care physicians that also explores if consultation is associated with increased patient knowledge/favorable attitudes about screening; an initiative to foster regional Training Excellence Centers (TECs) in Latin America where carefully selected service providers are trained in visual inspection with acetic acid (VIA) and cryotherapy using validated training materials and then serve as master trainers and support implementation of services.

Speakers:

Moderator: TBD

Carla Silva Matos, Ministry of Health, Mozambique; Establishment of a cervical cancer prevention program as a component of comprehensive reproductive health services: the experience of Mozambique
Jose Jeronimo, PATH; Implementation of training excellence centers for cervical cancer prevention in Peru
August Burns, Grounds for Health; The single visit approach to cervical cancer prevention: a demonstration model for effective, sustainable implementation in rural communities
Meenu Anand, American Cancer Society; Cervical cancer in India: partnering with primary care physicians in a community‐based demonstration project to address a public health problem

View available presentations:
August Burns | presentation
Carla Silva Matos | presentation
Jose Jeronimo | presentation
Meenu Anand | presentation

The changing face of malaria in maternal health

WHO's three-pronged approach says that pregnant women in stable malaria transmission areas should receive: an insecticide-treated net, intermittent preventive treatment, and prompt and appropriate treatment for malaria. Malaria incidence has dropped precipitously in some African countries. As countries consider changing strategies, the question remains whether capabilities are in place to detect and treat MIP, especially asymptomatic placental infections. This panel addresses four key issues for malaria in maternal health as efforts increase toward malaria elimination and the epidemiology of malaria changes.

Speakers:

Moderator: William Brieger, Jhpiego
Enobong Ndekhedehe, Community Partners for Development; Community involvement to increase IPTp & ITN coverage in a highly endemic area
Corine Karema, Ministry of Health, National Malaria Control Program; Feasibility of determining the prevalence of MIP during ANC
Theonest Mutabingwa, Hubert Kairuki Memorial University, Tanzania; The future MIP research agenda in the context of malaria elimination
John Eric Tongren, President's Malaria Initiative, USAID; PMI’s perspective on MIP programming in countries with changing malaria epidemiology

View available presentations:
Aimee Dickerson | presentation
Corine Karema | presentation
Theonest Mutabingwa | presentation
William Brieger-2 | presentation
William Brieger | presentation

Global Health Council

Global Health Council opens 38th annual international conference in Washington

2,000 participants from 70 countries expected to attend the world's largest global health conference not focused on a single issue and discuss securing a healthier future in a changing world read more…

Quality Assurance of Malaria Microscopy in Mali

The Improving Malaria Diagnostics (IMaD) project assessed the sensitivity, specificity and agreement of microscopists and their supervisors against Mali’s national referral laboratory, INRSP as gold standard. Low agreement between microscopists and gold standard was mainly due to low specificity, the former may be reporting stain precipitate and other artifacts as malaria parasites. Supervisors help identify what improvements they can introduce (i.e. filtering Giemsa stain) to reduce false positives. As a group, laboratory supervisors need to improve their sensitivity, while as a group microscopists must improve both their specificity and sensitivity. In the Venn diagram, the black square represents at scale the total number of slides used for external quality assurance, the blue circle represents slides reported as positive by INRSP, the red circle represents slides reported as positive by laboratory supervisors re-reading slides, and the green circle corresponds to slides reported as positive by microscopists. Eighty percent of false positives for supervisors overlapped the lab staff’s false positives, suggestive that some supervisors may not have been blind to staff results, which influenced their reports.

OTSS Accomplishments in Benin - IMaD

Rowe et al (Lancet 2005;366:1026-35) had suggested that “supervision and audit with feedback is generally effective” in achieving and maintaining high-quality performance of health workers in low-resource settings. IMaD conducts regular supervisory visits to a select sample of health facilities in Benin. In FY2010 IMaD visited a group of 60 health facilities 3 times each. Due to the staggared approach taken by IMaD for scaling up the number of facilities included in the intervention, only 36 of the 60 health faciities have been visited 4 times by the end of FY2010. During each round of supervisory visits, IMaD supervisors, who were previously trained in health facility evaluations and evaluated for malaria microscopy competency, collect information on the current state of health facility practices as they pertain to malaria diagnostics and treatment. During these visits the supervisors are also expected to provide on-the-job training for individual staff members should there be deficiencies in their performance conducting routine diagnostic procedures (e.g., malaria slide preparation, staining and reading), general laboratory practices (e.g., record keeping, stock issues, QA/QC schemes) or treatment of malaria (e.g., discussion of proper treatment). In FY2010 IMaD supervisors provided training to 100, 280, 234 and 137 laboratory staff and 83, 233, 137 and 84 clinical staff during the 1^st, 2^nd, 3^rd, and 4^th supervisory visits, respectively. Supervisors provide comments and feedback to health facility staff during each visit and suggest methods of improving specific practices when necessary. Maintaining continuity with respect to the cadre of supervisors routinely conducting the visits ensures accountability among the health facility staff to improve performance while fostering a reliable system of support at the same time. The following images show aggregate facility performance in malaria microscopy (staining and reading of malaria slides) as well as malaria treatment (prescriber adherence to negative malaria tests). For these particular data series, if IMaD interventions are positively received, one would expect to see an increase in the height of the bars for microscopy performance as the rounds of outreach progress and a decrease in the height of the bars for the proportion of health facilities prescribing antimalarials to patients with negative tests (which is, alternatively, a measure of prescriber adherence to malaria laboratory tests).

Video: Tackling Malaria through Private Sector Partnerships

Falling on World Malaria Day, this panel discussed the role of the private sector in the ongoing fight against malaria in the developing world. A distinguished panel of health and private sector professionals analyzed projects like those being implemented in Equatorial Guinea and assessed what lessons were learnt and can be applied in other contexts, specifically through this unique public-private partnership model.

Panel (From left to right): Dr. Luis Benavente [MCDI], Dr. Michel Slotman [Texas A&M] Dr. Chris Schwabe [MCDI], Dr. Adel Chaouch [Marathon Oil], Jennifer Cooke [Moderator from CSIS]

The presentation can be found here

Source: http://csis.org/multimedia/video-tackling-malaria-through-private-sector-partnerships

World Malaria Day 2011: Achieving Progress and Impact

This year's World Malaria Day theme---"Achieving Progress and Impact"---highlights recent successes in efforts to and causes global partners to take stock of what needs to be done to to reach near zero deaths by 2015.

Success and Challenges

In the last 10 years, funding has increased and many partners have stepped up efforts and joined together to scale up life-saving malaria interventions, especially in Africa.

For example, by the end of 2010, enough insecticide-treated bed nets (ITNs) had been delivered to sub-Saharan Africa to cover three-quarters of the 765 million people living in areas where malaria is transmitted.

Increased efforts and funding have led to progress and impact...more

Increased adherence to negative malaria test results in Benin

Previous studies http://www.ncbi.nlm.nih.gov/pubmed/10403337 have shown that clinicians often prescribe antimalarials to individuals with negative malaria tests.

Supportive supervisions done in Benin by NMCP and IMaD, USAID flagship for malaria diagnosis, show a reduction in the proportion of health facilities treating most patients with a negative malaria tests with antimalarials:

Many clinicians still write a prescription at the same time as a laboratory request because turnaround time is several hours long, rural patients won’t wait or won’t return for follow-up visits. Clinicians feel withholding antimalarials will put patients coming from remote villages at risk of dying.

IMaD will continue working to increase quality and timeliness of tests and the utilization of tests results in making therapeutic decisions.

Voices from the field

OUTREACH TRAINING AND SUPPORTIVE SUPERVISION FOR MALARIA DIAGNOSTICS

The National Malaria Control Program (NMCP) and the Ghana Health Service (GHS) realize that it is essential to deploy a comprehensive quality assurance program for malaria diagnosis and treatment, which includes use of microscopy an mRDTs, for diagnosis and improved fever management based on diagnostic results…more

Outreach Training and Supportive Supervision for Malaria Diagnostics

The National Malaria Control Program (NMCP) and the National Public Health Laboratory (NPHL) in Malawi realize that it is essential to deploy a comprehensive quality assurance program for malaria diagnosis and treatment, which includes use of microscopy and  mRDTs, for diagnosis and improved fever management based on diagnostic results.  In September 2010, the MOH, with support from the      Improving Malaria Diagnostics (IMaD)  Project, launched a quality assurance program that embraced both clinical and diagnostic aspects of malaria management by introducing the Outreach Training and Supportive Supervision (OTSS) program in 60 health facilities comprising 16 districts….MORE

Angola’s First WHO Malaria Microscopy Accreditation Course

On the week of September 13^th- 17^th, 2010, in close collaboration with the National Institute of Public Health and National Malaria Control Program, and with support from the USAID/PMI Mission of Angola, IMaD conducted the first ever Lusophone WHO Malaria Microscopy Accreditation Course (MMAC). Held in the capital, Luanda, twelve national expert microscopists participated in this exciting course designed to identify participant’s strengths and weaknesses in malaria microscopy….MORE

Integration and Capacity Building with BIMCP II

MCDI visit to training site in Mexico. In preparation for the training of the newly recruited officers, the outgoing and the incoming Deputy Project Managers visited the Instituto Nacional de Salud Pública in México (INSP-México). The visit allowed MCDI to meet the INSP team, and visit both their training site in Cuernavaca and the site that will eventually be used for the student’s field work. The principal outcomes of the visit included:

• Review of student housing options and preliminary discussions on safety, health insurance and life insurance provisions, issues pertaining to the students’ general wellbeing (mentoring, cultural exchange, and sports), rules and responsibilities, and exposure to ample and practical field experiences.
• Finalization of pending operational issues prior to MCDI’s signature of the contract with the INSP-México.
• Assessment of classrooms, conference-rooms, libraries, laboratories; computer/internet facilities, cafeterias, sport facilities via visits to the INSP -México campuses in Cuernavaca and Mexico City.
• Visits to field sites where project activities will take place to become familiar with the situation on the ground.
• Information exchange on the planned visit by a team from the INSP to Equatorial Guinea.

Between August 9 and 15 2010, three lecturers from the INSP-México, Dr. Angel Francisco Betanzos Reyes (Lecturer-Program Coordinador), Dr. Armando Ulloa García (Lecturer, Entomology) and Dr. Jorge F. Méndez Galván (Lecturer-Researcher ), visited Equatorial Guinea. Some of the highlights of their visit included:

• An assessment of the local context via meetings, interviews and field observations including visits to hospitals, health centers and communities.

 

l-r: Jorge F. Mendez-Galvan, Denise L Harrison, Angel Francisco Betanzos Reyes, Leonor Ada, Armando Ulloa Garcia , Dr. Gloria Nseng, Victor Mba, Maria-Cecelia Engono, Raul Nguema, Dr. Martin Eka, Javier Nve

• Information exchange with MCDI program staffs from the BIMCP and the EGMCI on the Continent.
• Interviews with the 8 new NMCP personnel (students) and with MSBS authorities.
• Analysis of multiple documents, publications and data provided by MCDI and by the Director of the NMCP.

New NMCP officers visit MCDI offices in Silver Spring en route to Mexico. The eight new NMCP officers travelled to Silver Spring MD and Washington DC on August 30, 2010 for an intensive one week orientation prior to traveling on to Cuernavaca, Mexico. During this week the students visited the Marathon and MCDI Headquarters, the Embasssy of Equatorial Guinea, the Consulate of Mexico and the Capitol Hill office of US Senator from the State of Maine, Olyimpia Snowe. Following these initial visits MCDI organized a series of malaria-specific visits to the Pan American Health Organization (PAHO) and the President’s Malaria Initiative/USAID offices. In addition, the orientation program included a tour of historic sites in Washington. Highlights of the visits included:

• A memorable welcoming dinner hosted by Dr. Adel Chaouch, Director of Corporate Social Responsibility for Marathon Oil. The relevance of the training and the high expectations the country has for the trainees on their return to EG were underlined.
• A meeting with Her Excellency the Ambassador of EG in Washington, Ms. Purificacion Angue Ondo, to explain the seriousness of their training visit to Mexico and to ratify the student’s commitment to the Program through the signature of an agreement between the Ambassador and the students.
• A visit to Senator Snow’s office to expose the group from EG to the US Senate and the interest it has in global health, sharing with the Senator’s staff information about the BIMCP and the role that a Maine organization (MCD) plays in its success, and highlighting the support that MCDI gets from Marathon Oil in support of the project.

L-r: Martin Eka Ondo Mangue, Pablo Aguilar Alcalá, Javier Nve Adjaba E., Magdalena Serpa, Victor Mba Micha A., Raul Nguema Nkogo O., Excm. Purificación Angue O. Embajadora de GE en EUA , Teodosia Evuna Ayetebe, Maria C. Engono Nguema, Epifanio Bula Malest, Leonor Ada Okenve, Chris Schwabe, Adel Chaouch, Joseph Carter

• A presentations on the history, achievements and plans for the future of BIMCP I and II, with emphasis in the integration plan/empowerment of NMCP to manage and implement interventions and activities that are now being managed with extensive external technical assistance provided by the BIMCP.
• Presentations on the plans for training in Mexico including on the context, objectives; performance expectations, performance monitoring, communications, code of conduct, and the implications of not following rules, or maintaining an acceptable level of academic performance.
• Visit to PAHO and to USAID’s President’s Malaria Initiative to familiarize the students with the history and current state of malaria control in the Americas and Africa.

New NMCP officers travel to Mexico. The eight new NMCP officers travelled to Mexico on September 4 accompanied by Dr. Serpa, the BIMCP Deputy Program Manager. After settling into their housing and meeting the staffs of the INSP, they began classes on September 6. The first 3 months of the program will focus on general knowledge pertaining to public health and malaria control. This will be based on course work in Cuernavaca and Mexico City and short field visits.

Special focus on health, safety and security. MCDI has worked with the INSP and Marathon Oil to ensure that the health, safety and security concerns of the students is fully addressed. Each student has been enrolled in a private health insurance scheme that is being financed by the BIMCP and a detailed safety and security protocol and procedures have been put in place and reviewed with the students. Periodic reinforcement of these guidelines will be undertaken with the students as a preventive measure. Special arrangements have also been made for visits outside Cuernavaca in order to ensure that the safety and security of the students is assured. These procedures have been reviewed and approved by Marathon and the INSP.

IMaD End of Year 2010 Update

During 2010, IMaD expanded activities and is now operational in 13 countries throughout sub-Saharan Africa. To date, IMaD has trained over 1200 laboratory staff, clinicians and health workers in diagnosis of malaria, RDT usage, Outreach Training and Support Supervision training, and data entry and analysis. An additional 38 Ministry of Health were sponsored by IMaD to participate in the WHO External Competency Assessment for Malaria Microscopists. IMaD, in collaboration with the local Ministries of Health, has also launched national quality assurance programs in 7 countries covering over 600 health facilities.

The third IMaD Annual Planning Meeting was conducted from December 6 -10, 2010 in Silver Spring, Maryland.  Since IMaD began in 2007, IMaD staff and partners get together to review the year’s progress and way forward.  Every year, In Country Coordinators (ICCs) that help to implement the IMaD programs in their respective countries attended.  ICCs  from Benin, Ghana, Liberia, Malawi, Mali, and Zambia as well as partners from AMREF and Hydas World Health were present.  Representatives from the CDC and USAID/PMI Washington attended sessions on the 8th and 9^th of December.

Topics covered included:

-Country Overviews – each ICC presented on his or her experience in their respective country

-RDT Roll Out Plans

-Review of the IMaD Database, Checklist and other OTSS tools

-Strategies for Sustainability and Transition in IMaD countries

-Management and Finance Issues

-The Way Forward

MCDI would like to extend a note of appreciation to the IMaD In-Country Coordinators in Benin,  the Democratic Republic of the Congo, Ghana, Liberia, Malawi, Mali and Zambia; our partners at the African Medical Research Foundation and Hydas World Health; and Professor Daouda Ndiaye and colleagues at the Université Cheikh Anta Diop. Without all of their valuable contributions, our success would have been impossible to achieve and sustain. 

To view IMaD’s Quadfold Brochure click here…