1 LUCSA/ELCA Regional Malaria Program: Update and Future Perspective Prepared by: Lucas Owuor-Omondi

Goal The overall goal of the LUCSA/ELCA Regional Malaria Program is to contribute to the reduction of morbidity and mortality due to malaria, particularly among pregnant women and children under- five as well as among vulnerable population groups. 2

Objective To empower congregations and surrounding communities to reduce the risk and vulnerability to malaria infection and to alleviate the impact of the disease and disease condition on the affected households, with a strong focus on children under five years, pregnant women and the disadvantaged from the hard to reach areas. 3

Coverage The five targeted countries are Angola, Malawi, Mozambique, Zambia, and Zimbabwe. 4

Coverage (e.g.) - Mozambique 146 Congregations, 146 Congregational Development Committees (CDCs), 14 Parish Development Committees (PDC), 3 (three) District Development Committees (DDC), 730 Activists, 85 Clinical Officers/Nurses, 135 Traditional Health Workers, 146 Youth groups and 146 Women groups. 5

Coverage - Mozambique The primary beneficiaries are the inhabitant of the 3 proposed areas covered by the Program: people (7.237 women- 56%) The secondary beneficiaries are the neighboring populations of the targeted districts in Nampula, Cabo Delgado, Tete, Zambezia, Manica, Sofala, Gaza and Maputo City. 6

LUCSA/ELCA Regional Malaria Program: An Opportunity The Program presents an opportunity to LUCSA to contribute to the strengthening of the organizational and development capacity of member churches with a view to enhancing their efficiency, effectiveness and responsiveness to enable them to address the problem of malaria and related needs of the congregations and surrounding communities. 7

Strategic Priorities: Pillars 1. Institutional Capacity Building 2. Malaria prevention, control and management 3. Treatment 4. Sustainable Livelihood 8

Collaboration and Partnership: Zambia Zambia by far has demonstrated high level of networking between partners with more faith being given to the church. A lot of responsibilities have been put the church as a result of partnership created: e.g.: Ministry of Health, National HIV and AIDS, Human Rights Commission 9

Most Significant Changes 10

Most Significant Changes “The malaria campaign programme has really helped. There has been notable reduction in the burden of the disease in the area. Before the program started, people only slept in the mosquito nets during rainy seasons when mosquitoes are plenty but now we all sleep under the mosquito nets throughout the year and this has reduced the number of malaria cases in our village. For example my son will never go to sleep not until he is covered with a mosquito net. We now know how to protect ourselves and we are not spending on medicines any more.” (A mother in Simaubi – Zambia) 11

Most significant Changes (cont..) “This is a very good programme please may the Lord bless you for bringing this programme here. We thank the Lutheran church for bringing VCT to our area. This is the first time we are having something like this. Today we have had people to teach about public Health, Reproductive health, TB and HIV/AIDS. We thank the Project Coordinator for bringing these people to this area especially the people who have talked about reproductive health. We have a problem here that children start having babies when they are still young instead of concentrating on education, because of this we have a lot of girls who are school dropouts in this area.” An Elder in Mulimba - Zambia 12

Most Significant Changes (Cont..) “It is very encouraging to see our headman calling for Malaria sensitisation meetings at his home. Since the time our headman came from the training workshop which was conducted by the ELCZa/LECA Malaria campaign programme in Zambezi so far he has held about three Malaria Campaign meetings. He is also involved in the teaching and he tells us that he doesn’t want to see anyone in his village die of malaria because it’s a disease that is curable, treatable and preventable.” (An Elder in Dipalata Congregation – Zambia) 13

Most Significant Changes (Contd..) “I have learned not to wait till it is late to take a sick person for testing and treatment within ’24 hours’! Joaquim Cardoso (33) married with 5 children, an Activista in Namacaua - Namina in Mozambique recalls with a lot sadness and pain, how his own child died of malaria. Speaking in his native language Emakua, Senhor Joaquim recognizes the seriousness of Malaria as a deadly disease by recalling the title of a song sung by the activists during the door-door sensitizations campaigns, households visits - ‘Malariayala Nikassope!’, which they use to drive the point home that malaria is preventable 14

Some Statistics: Mozambique The Clinic at Namina town in Nampula Province in Mozambique reports: “The cases of malaria have significantly reduced during the first semester 2012 as compared to the same period last year (2011), from 1, 982 cases to 1,129 diagnosed cases respectively!” This represents a 43% decrease in malaria cases from one year to the next. (Litos Manuel, General Medical Technician, Namina) 15

Some statistics: Zambia 1,099 church, community and traditional leaders were trained and 6,300 information, education and campaign materials on malaria specific behavior change were distributed. 4 open clinics were conducted and 2,031 with symptoms of malaria were tested 16

Some Statistics: Zambia (cont..) Out of the 1,484 who tested positive during the four open clinics were treated. 17

Some Statistics: Zambia (contd..) Between Jan-Sept 2012 the malaria livelihood program managed to reach a total of five hundred and nine people (509) 264 males and 245 females in 12 Villages covered by the program. 18

Some Statistics: Zimbabwe 58 awareness sessions were carried out by Malaria Focal Persons, from January – June, or about one session every three days. 3,107 people were reached through training programs on signs and symptoms of malaria, prevention methods, environmental management and treatment. 19

Some Statistics: Zimbabwe (cont..) 692 community members were trained in malaria treatment methods including Rapid Diagnostic Testing, Intermittent Preventive Treatment and early treatment-seeking behaviors 20

MozambiqueAngolaMalawiZambiaZimbabwe % HH with mosquito nets 57%37%67.3%70.4%41% % HH with at least one ITN 28.4%35%56.8%64%28.8% % of children <5 years who slept under an ITN a night before the interview 17.5%26%39.4%50%30.3% % of pregnant women who slept under an ITN the night before the interview 19.5%35.2%47.7%9.7% % of women who during the pregnancy that occurred in the last two years took two or more doses of SP/Fansider 18.6%18%55%70.2% % of children <5 years who had fever during two weeks preceding the interview 13.4%34%34.5%34.1% % of children <5 years who had fever in the last two weeks preceding the interview and who took antimalarial either within 24 or 48 hours 22.2%16.4%28%18.7% 21

The Challenge It is arguably unrealistic to suggest that malaria can be eradicated from much of tropical Africa, but it is entirely reasonable to assume that the burden can be reduced such that malaria is no longer considered a priority public health problem. 22

Monitoring and Evaluation LUCSA will utilize the following FIVE core indicators as a basis for measuring change brought about by the Program: 1. Reduction in malaria morbidity and mortality. 2. Improvement in target households and communities capacity to prevent, control and manage the disease. 23

Monitoring and Evaluation 3.Organizational Development and Systems Strengthening of member churches to ensure: upward and downward accountability; effective response to emerging issues; timely and quality services; effective resource mobilization, management and control; and documentation and sharing of best practices. 24

Monitoring and Evaluation 4.Linkages between the Regional Malaria Program and other sectors of government and other key actors. 5.Technical support and partnership building. 25

A Call for Partnership “The will to sustain the gains we have made in malaria must come not only from politicians, but from affected communities. If communities can know the true burden of malaria and can see the results of prevention and control efforts, then the will to eliminate and ultimately eradicate malaria will never fade.” Dr Margaret Chan, Director-, General – WHO 26

Thank You …! 27