The Benefits of Positive Community Case Management of Malaria Uptake in the Community, Case of Sigwata Village in Matayos Sub-county, Busia County.

Community case management of malaria (CCMm) forms a key pillar in malaria management in endemic counties as per the Kenya malaria strategy 2019-2023. According to the Kenya Malaria Indicator Survey 2020 (KMIS), Busia county leads in malaria prevalence at 39%. With this high prevalence, malaria is the leading cause of morbidity and mortality in Busia County and the highest contributor of outpatient and inpatient cases at the health facilities. Therefore, through CCMm the Community Health Volunteers (CHVs) take part in early active case detection through testing of suspected uncomplicated cases in the community and treatment of confirmed malaria cases using ALs.

Matayos Health centre is a sub county referral hospital in Matayos sub-county, Busia County. The hospital has a catchment population of 23,598 persons with five community units linked to it. The fivecommunity units were trained on (CCMm) under the support of Global Fund to support in testing and treatment of uncomplicated cases in the community and help reduce the number of malaria cases at the facility. This is a great strategy that is aims to reduce the facility workload and provide an opportunity for the health facilities to handle other conditions that can not be handled by the CHVs. In 2022 the fivecommunity units tested 60% of all the suspected malaria cases under the catchment population and treated 82% of all the positive cases. This is a positive shift where more cases are handled at the community visa vee the facility if compared to the period 2019 to 2021 where there were more malaria cases handled at the facility.

According to Josephine Achieng a CCMm beneficiary, a wife and a mother of fourchildren from Sigwata Village in Busende CHU, the community health volunteers have played a key role in malaria management in the village. This is through testing, treatment of uncomplicated malaria cases, health education on prevention and behavior change on malaria prevention practices. She further states that through the work of the CHV, Mr. Calisto Oketch, there is reduced time wastage in case management as the CHV is a phone call away to offer the much-needed services. This according to her, plays a key role in cost reduction due to the high transportation cost to the far reaching near- by facility six kilometers from the village. This is evident during the case management of her 3rd born child who had been presented with fever, headache and joint pains that very morning. Upon call out to the CHV the malaria Rapid Diagnostic Test(mRDT) used by the CHV turned positive for malaria. The child is later treated using the Artemether Lumefantrine tablets, a dosage for three days.

Busende CHU leads in the number of malaria cases tested in Matayos health centre catchment population. This is affirmed by the presence of water streams around the villages which act as mosquito breeding sites. Calisto the CHV in Sigwata village, confirms that in his village, there are approximately 45 suspected malaria cases on average in a month. In his MOH 648 register for malaria case management and commodity accountability, Sigwata village in the month of January 2023 had a total of 47 suspected cases out of which 45 cases were confirmed positive and treated in the community. This is enabled by the supply of adequate malaria commodities by the link facility, continuous mentorship and support supervision by the Community Health Extension Workers (CHEWs) for quality service delivery by the CHV.

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