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credit attribution: The Global Health Delivery Project, GHDonline.org,
Feb 04, 2013.
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Added on 04 Feb 2013
Authors: Sungano Mharakurwa, PhD
- Local community engagement, education, and buy-in: The case of Macha shows that long-term local presence, engagement and education of the target beneficiary community can make a difference. MIAM was introduced to the resident community as well as the nation with due attention to local norms and leadership structure. The facilities were built by local contractors in collaboration with international partners. As a result, MIAM was received well at all levels, with strong local trust and high participation in intervention campaigns. MIAM also established rapport with traditional healers, who feel free to refer malaria patients for modern medication at the locally-owned institute and affiliated Macha Mission Hospital.
- A multi-pronged Model: As Dr. Thuma pointed out it is not easy to tease out one intervention as having impacted against malaria, since multiple strategies are deployed, including health education, screening and ACT treatment of the asymptomatic carrier reservoir, reactive case detection using mobile phones and other locally developed strategies. LLINs are also used.
- A Healthy Economy is Conducive to Successful Control: MIAM has observed improvements in the national and local level economy, itself contributing by employing community members. Improved economic conditions are believed to have been conducive to the successful experience at Macha, as shown elsewhere. Furthermore, improved housing conditions and affordable electricity are key factors in the fight against malaria. He notes that “Mauritius and Turkmenistan reached stable and very effective suppression of malaria at the same time that they provided affordable electricity out even to rural areas.”
- Public-Private-Partnership: Some interventions at MIAM were rolled out in concert with Roll Back Malaria with a “can-do” attitude. MIAM also works well with the WHO, Global Fund, USAID, PMI, Norvatis and other partners.
- No “one-size fits-all”: Hopefully the Macha experience can be replicated elsewhere. However, as pointed out in the discussion, there is no universal panacea. What is effective in one area may not work elsewhere, and local adaptation is important to maximize impact.
- WHO: World Malaria Report 2012. In. Geneva, Switzerland; 2012.
- Kamanga A, Moono P, Stresman G, Mharakurwa S, Shiff C: Rural health centres, communities and malaria case detection in Zambia using mobile telephones: a means to detect potential reservoirs of infection in unstable transmission conditions. Malar J 2010, 9:96. (full text)
- Shiff C, Thuma P, Sullivan D, Mharakurwa S: Designing a sustainable strategy for malaria control? Malar J 2011, 10:220. (full text)
- Stresman GH, Kamanga A, Moono P, Hamapumbu H, Mharakurwa S, Kobayashi T, Moss WJ, Shiff C: A method of active case detection to target reservoirs of asymptomatic malaria and gametocyte carriers in a rural area in Southern Province, Zambia. Malar J 2010, 9:265. (full text)
- Sutcliffe CG, Kobayashi T, Hamapumbu H, Shields T, Kamanga A, Mharakurwa S, Thuma PE, Glass G, Moss WJ: Changing individual-level risk factors for malaria with declining transmission in southern Zambia: a cross-sectional study. Malar J 2011, 10:324. (full text)
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