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).