MALARIA

ABOUT MALARIA PROGRAM

More than 70% of Kenyans are at risk of malaria. This preventable disease is responsible for the loss of 170 million working days each year and 13 percent of all deaths among children under five (34,000 deaths). Malaria still accounts for 16%, of outpatient attendances according to the September 2014 HMIS data.

The vision of the revised Kenya’s National Malaria Strategy 2009 – 2018 is to have a malaria free country through achievement of six key objectives. The objective one target to have at least 80% of people living in malaria risk areas using appropriate malaria prevention interventions by 2018. Key strategies to achieve this objective include distribution of LLINs through appropriate channels i.e. Mass net distribution targeting malaria endemic and epidemic prone regions, routine distribution through clinics and social marketing approaches in endemic, epidemic prone and some seasonal malaria transmission areas in Kenya. Indoor residual spraying in targeted areas, supporting the malaria free schools initiative and providing IPTp at antenatal clinics are complimentary initiatives. PS Kenya’s key areas of implementation in Malaria include:

Net Distribution

• Objective: Reduce mortality due to malaria by increasing LLIN (long-lasting insecticide-treated nets) ownership and use. PS Kenya is the leading partner in routine EPI/ANC LLIN distribution in Kenya targeting 36 malaria endemic, epidemic prone and some seasonal transmission counties which are spelt out in the Kenya Malaria Strategy. Based on target population need (pregnant women and children under 1) per target county, PS Kenya distributes approximately 200,000 LLINs per month and on average 2.4 Million LLINs per year through this routine channel. In addition, PS Kenya through the US Presidential Malaria Initiative (PMI) funding, successfully completed a Mass net distribution of 3.8 million nets in 5 targeted malaria epidemic prone counties in Western and Nyanza covering approximately 7.6M people. Leveraging on DFID funding, approximately 800,000 social marketed nets have been distributed on an annual basis.

Other Successes

Based on national representative surveys, net ownership of at least one net of any type increased from 57% in 2010 (KMIS) to 68% (TRaC 2014) but reduced to 65%(KMIS 2015). There has been an increase in HH with at least one LLIN from 44% (KMIS 2010), 54% as per Malaria TRaC 2014 to an all-time high at 63% (KMIS 2015). A higher proportion of household in Malaria Coast endemic (73%), Lake endemic (89%) and epidemic prone regions (73%) were more likely to have at least one LLIN as compared to HHs in other Malaria areas. However, apart from Lake endemic region, this is lower than the national target of 80% coverage. Universal coverage (1 net for every 2 people) is still very low nationally having marginally increased from 38% (TRaC 2014) to 40% (KMIS 2015).

BCC to Increase Net Use

PS Kenya plays a leading role in partnership with the MOH in behavior change communication to bridge the gap between net ownership and net use. PS Kenya utilizes innovative evidence-based behavior change communication techniques to address barriers to net use. These include both mass media and interpersonal communication (IPC) to ensure a “surround and engage” approach. IPC channels include both one-on-one household visits and small group sessions where communities are gathered national average.

Results from national representative surveys (KMIS 2010, Malaria TRaC 2014 and KMIS 2015) show that our efforts are achieving results. For instance, use of ITN was higher among children under-five years of age (under-fives) and pregnant women in HHs that had access to an ITN as compared to the general HHs. For HHs with access to at least one net of any type, a higher proportion of under-fives (79%) slept under any net in 2015, compared with 73% in 2014 and 71% in 2010. The same trend was observed in pregnant women use of ITNs in HHs that had access to at least one ITN which increased from 73% in 2010, 77% in 2014 and 82% in 2015.

Capacity Building the national and county malaria teams

For effective oversight, linkages and malaria program implementation, a fully functional system including motivated staff at both national and county level are a necessary ingredient. To improve the capacity of the Kenya government, that is, the Ministry of Health at both national and county level to facilitate malaria control interventions, PS Kenya has been providing technical support to the National Malaria Control Program (NMCP) through participation in technical working groups, including case management, vector control and operational research. This has resulted in improved malaria program management.

Private Sector Fever Management

Goal: Increase the use of quality assured mRDTs to improve fever treatment PS Kenya implements this in private health facilities and pharmacies in the Coast region by focusing its interventions in Sales and BCC, Quality Assurance and Policy.

To increase availability of quality assured RDTs, the pilot procured and sold/distributed 500,000 RDTs to private providers and pharmacies over the life of the project.

To increase demand, a two- pronged communication campaign targeting consumers and providers was implemented resulting into a 15.4% increase in the proportion of caregivers who could cite a private provider source of RDTs (from 10% at baseline to 25.4% at midline) and 73.6% of private providers initiated malaria driven testing with 30.4% testing with RDTs (Client Exit Survey,2015.

Capacity Building the national and county malaria teams

For effective oversight, linkages and malaria program implementation, a fully functional system including motivated staff at both national and county level are a necessary ingredient. To improve the capacity of the Kenya government, that is, the Ministry of Health at both national and county level to facilitate malaria control interventions, PS Kenya has been providing technical support to the National Malaria Control Program (NMCP) through participation in technical working groups, including case management, vector control and operational research. This has resulted in improved malaria program management.

OUR IMPACT

PS Kenya distributes approximately 200,000 LLINs per month and on average 2.4 Million LLINs per year through this routine channel. In addition, PS Kenya through the US Presidential Malaria Initiative (PMI) funding, successfully completed a Mass net distribution of 3.8 million nets in 5 targeted malaria epidemic prone counties in Western and Nyanza covering approximately 7.6M people. Leveraging on DFID funding, approximately 800,000 social marketed nets have been distributed on an annual basis.