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Scaling up community management of malaria - challenges and successes in EMRO countries. ICIUM2011 malaria/TB panel discussion 17 November 2011 Dr Hoda Y. Atta . LEVELS OF MALARIA CASE MANAGEMENT INTERVENTION. HOME. Community. Peripheral H.S. Hospital. Early Diagnosis , Treatment
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Scaling up community management of malaria - challenges and successes in EMRO countries ICIUM2011 malaria/TB panel discussion17 November 2011Dr Hoda Y. Atta
LEVELS OF MALARIA CASE MANAGEMENT INTERVENTION HOME Community Peripheral H.S. Hospital • Early Diagnosis , Treatment • Referral • Hospital-based Management
Challenges of Universal Access to Effective Treatment • > 30 -70% of cases occur outside the public health facilities • >50% childhood deaths occur without contact with public health services, 90% deaths occur within 48 hrs of onset of illness • Self-medications, in sub-optimal dosage are widespread • unregulated informal private sector • Marketing artemisininmonotherapy, despite the policy to ban it and national adoption of ACT • Availability of fake , poor quality antimalaria medicines in the market
How to increase access to effective treatment ? CBMM : Afghanistan in 2010 adopted a National Strategy to enhance access to effective malaria treatment in the community through involving trained volunteers in recognition and treatment of malarial illness
Information/educationfor CBMM • Recognizing malaria symptoms • Taking appropriate actions for mild cases • Adhering to treatment dosages • Assess severity, provide supportive care and referral of sever cases
Challenges to implement CBMM…. Setting up community referral systems Record keeping and reporting tools Quality assurance of ACT and RDT at the point of care Supervision and monitoring community activities Motivation and retention of the community based providers
CBMM Public Health Gains Studies have shown good outcomes and impact Under-five overall mortality reduced by 40% (Kidane, 2000) Reduction in severe disease by 25-50% (Pagnoni et al 1997;Sirima et al., 2003) Achievement of MDGs and the global target of 80% access to prompt effective treatment within 24 hours of onset of symptoms will be through provision of quality affordable antimalarialtreatment wit diagnosis near-the-home.