Center for Health Market Innovations (CHMI)

Programs

Integrated Malaria Control Program

last updated Oct 18, 2011

Overview

Implementing organization: 
Concern Worldwide, The International Rescue Committee, and World Relief
Implementation Partner(s): 
Ministry of Health Rwanda, National Malaria Control Program Rwanda
Legal Status: 
Public-private partnership
Year Launched: 
2005
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Donor
Additional Source(s) of Funding: 
Government
Funders: 
CORE Group, The Global Fund to Fight AIDS Tuberculosis and Malaria (GFATM), the U.S. Agency for International Development (USAID), Tuberculosis

Scale

Other Measures of Scale: 
The program has supported the training of 668 Community Health Workers (CHWs) in Kirehe district—the first group of CHWs in the country to be trained on this community-based method for managing and treating childhood illnesses.
Replication: 
Later, the program has decided to extend pilot to all health centers in the three health districts of Kibilizi, Kirehe and Kibogora
Summary: 

The Integrated Malaria Control Program was created in 2004 as a pilot program which later commenced in 2005. The program is collaborating with health management teams and three international private voluntary organizations (PVOS) to provide guidance, training, and all medications. These private voluntary organizations and their local partners are using existing child survival programs to implement and monitor the programs. In doing so, the program is assured of reducing malaria infections to the vulnerable people.

Program goals/rationale: 

The overall goal of the program is to pilot-test the ability of community health workers to provide front-line anti-malarial treatment in rural community settings. Specific objectives include:

  • To increase the proportion of children under 5 years of age with uncomplicated malaria who received correct treatment from a trained provider within 24 hours of the onset of symptoms to 60% as per the Rwandan Target;

  • To demonstrate that community health workers can appropriately use simple case management guidelines for children under 5 with fever;

  • To increase caregivers’ awareness of the danger signs of malaria in children.

Key program components: 

The Ministry of Health recommended two major strategies to lessen the burden of malaria: 1) the use of insecticide-treated bednets for prevention, particularly among vulnerable groups including pregnant women and children under 5; and 2) early diagnosis and treatment with combination therapy amodiaquine and sulfdoxine/pyrimethamine.

To improve compliance, the Ministry of Health has arranged for blister packets containing a complete course of treatment to be made avail-able at a subsidized price of 20 cents (US). To address the related problems of high malaria mortality and low use of health facilities, the program has collaborated with the Ministry of Health’s National Malaria Control Program to authorized the distribution of first-line antimalarial medication by community health workers. The National Malaria Control program has decided to implement the policy in a few districts initially, and has chosen sites that benefit from child survival support from organizations including Concern, IRC, and World Relief (Kibilizi Health District in Butare Province with Concern Worldwide, Kirehe Health District in Kibungo Province with IRC, Kibogora Health District in Cyangugu Province with World Relief). Later, the program extended the pilot to all health centers in the three health districts of Kibilizi, Kirehe and Kibogora.

Major successes include training community health workers to treat pneumonia in children at its first warning signs, launching the program in two new districts, and using the drug artesunate-combination Coartem® for malaria treatment. Further steps have been taken toward integrating home-based management of fever with Community Integrated Management of Childhood Illness (C-IMCI) and into the overall Community Health structure of the Ministry of Heath.

Program history: 

The Rwanda National Integrated Malaria Control Program collaborated with health management teams and three international private voluntary organizations (PVOs) – Concern Worldwide, The International Rescue Committee, and World Relief – to implement a pilot program for community-based distribution of antima-larial medication in Kibilizi, Kiboga, and Kirehe districts. The program was funded by the CORE Group, the U.S. Agency for International Development (USAID), and the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM).

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