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Working with communities to tackle malaria in Uganda HENRY TITO OKWALINGA PROJECT OFFICER, MALARIA, AMREF UGANDA. OVERVIEW. About AMREF Malaria in Uganda AMREF & GSK’s Uganda Malaria Partnership Programme (UMPP) Lessons Learned. ABOUT AMREF.
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Working with communities to tackle malaria in Uganda HENRY TITO OKWALINGA PROJECT OFFICER, MALARIA, AMREF UGANDA
OVERVIEW • About AMREF • Malaria in Uganda • AMREF & GSK’s Uganda Malaria Partnership Programme (UMPP) • Lessons Learned
ABOUT AMREF • AMREF improves the health of poor people in Africa through: • Building capacity of local institutions to manage and deliver affordable, accessible health care • Empowering communities to engage in health delivery • Piloting and replicating innovative approaches to health development. eg: through harnessing new technologies, such as eLearning and telemedicine • Health systems research to influence policy and practice • AMREF targets the most vulnerable: mothers and children, nomadic populations, IDPs and people living in remote rural areas and urban slums.
THE MALARIA SITUATION IN UGANDA • Malaria is number one killer of children in Uganda • 95% of Uganda subject to intense perennial malaria • Key risk groups are children under five, people Living with HIV/AIDS and pregnant women • Malaria accounts for: • 51% of out patient department attendances • 47% of under five mortality • 30% of deaths during pregnancy
THE UGANDA MALARIA PARTNERSHIP PROGRAMME (UMPP) • Project developed in response to GlaxoSmithKline's African Malaria Partnership focus on community behaviour change and AMREF’s focus on community-based health care • Implemented in 3 districts in Uganda over 3 years, targeting children under five and pregnant women • Operated as a consortium with four NGOs and in collaboration with district health services • Funding and technical assistance provided by the GlaxoSmithKline Africa Malaria Partnership • Technical support and guidance provided by Ministry of Health (MOH)
UMPP GOAL To reduce malaria related morbidity and mortality among children under five years of age and pregnant women STRATEGY • Promote use of ITNs by both pregnant women and children under five • Promote home based management of fever (HBMF) among under fives • Promote Intermittent Presumptive Treatment (IPT) of malaria in pregnancy
IMPLEMENTATION Partnership with Government • Formation of District and Sub-County Coordination Committees • Partners Review Meetings with Ministry of Health Building Local Capacity • Training of Community Medicine Distributors (CMDs) and health workers • Support of CMDs at household level • Communications materials, film shows/drama to promote HBMF, IPT and ITNs Accelerating Replication • Documentation and dissemination workshops to accelerate replication of project activities • Supported sub-county and district leaders to develop annual malaria plans and budgets to ensure sustainability of UMPP activities
RESULTS ITNs • High demand for ITNs • An increase in households with one ITN from 25% to 76%. Morbidity and Mortality • Reduction in cases of complicated malaria among under fives from 25% to 3.2% • Reduction of malaria-related deaths among the U5s from 6.4% to 0.1% • Reduction of malaria episodes among U5s in a year from 6 to < 3 • An increase in children receiving treatment for fever within 24hrs from 34% to 84%
RESULTS contd Retention of CMDs • A drop out rate of CMD volunteers of 6.8% (vs 37% in non-UMPP districts) Scale-Up • Using UMPP models, AMREF has secured over $7 million for scale-up in central and northern Uganda • CMD model adopted by Government of Uganda and scaled-up in 72 districts
LESSONS LEARNED • Highlighted the importance of community based behaviour change communication to reduce morbidity and mortality due to malaria • Maintaining high levels of CMDs performance and retention requires provision of effective training, support and incentives • Decentralisation channels resources directly to beneficiaries, actively involving them in the activities and ensuring that donor money reaches the grass roots • Working in close partnership with Government contributes to national-lead initiatives, accelerates scale-up and builds local capacity
Thank-you • To GlaxoSmithKline’s Africa Malaria Partnership • To Ministry of Health in Uganda • To Malaria Consortium for technical support • To our partners – Africare, Uganda Red Cross and Communication & Development for Uganda