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    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.


    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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The Kenya NGOs Alliance against Malaria (KeNAAM) is a network of non-state actors working towards preventing, controlling and reducing the high death rate as a result of malaria. Eyes on Malaria correspondent Isaiah Esipisu interviewed the network's Chief Executive Officer Edward Mwangi, to find out how the fight against malaria has been in Kenya.

Q. Why is KeNAAM relevant in the fight against malaria?

A. KeNAAM’s existence is based on the realisation that no single  institution can win the battle  against malaria. It was therefore  formed to look at four important  things  including  information coordination, mapping of malaria partners  in  the  country,  resource mobilisation and advocacy.

For example, in early 2000, there was a problem of proliferation of counterfeit drugs,  resistance  to  malaria  medicines, and low  coverage of bed-nets. KeNAAM therefore came in to advocate for  increased resources and also  increased  visibility  for  malaria. And that is the reason why Kenya has achieved so much in terms of the fight against  malaria  compared  to  other countries without such mechanisms.
Q. Members of KeNAAM include  the Civil Society Organisations. Why  are such organisations important  in  the fight against malaria?

A. Civil society organisations are very important because they  connect the last mile. Until 2006  when the health strategy started in Kenya, the primary healthcare in the country was not fully functional  because  there  were  no 'level one' services – where communities  take responsibility for their health. Still the same, the country has only 20 percent  of the required number of community health workers.  Civil  society  has  therefore taken  the  responsibility  to  supplement government's effort in this area.

Q.  What  key  achievement  have  we realised under the umbrella of KeNAAM

A.  We  have  realised  many  achievements over the past 10 years. Primarily, we can say that  the  reduction  of child  mortality  due  to  malaria  in Kenya by 36 percent is a key achievement, which KeNAAM  and its partners played a big role to realise. In  early  2000  for  example,  many people  travelling  to  the  coastal region  had  to  take  medication  in advance,  and  identify  some  good hospitals where they would  go for treatment, even before  booking for the transport ticket.

But now, the prevalence has reduced in  the  whole  country,  except  the Nyanza  region.  Save  for  the  South coast region which has a prevalence of 20 percent, the prevalence in other parts of the coastal region has drastically reduced from 80 percent to less than five percent.

Q. What challenges does Kenya have in the fight against malaria, given the effective tools already in place?

A.  The  biggest  challenge  at  the moment  is  the  uptake  of  malaria interventions.  The  tools  are  avail- able,  and  they  are  highly  effective.

But people are not seeking  treatment in good time. We still have people going to the hospitals way  beyond 24 hours of  fever.  According  to  the  Malaria Indicator  Survey  of  2010,  only  24 percent of people with fever  reported to the health facilities within the period of 24 hours.

Again, the level of investment in terms of domestic financing is still  very low. Currently, almost 90 percent of malaria interventions including distribution of mosquito nets, indoor residual spraying among others are all  funded by donors. If such partners  decide to pull  out  then  there will  be an acute increase in infections.

As a country, what we are saying is that we are sick, and we should realise that it  is  not  the  responsibility  of  the partners to take us to the hospital. We should be able to plan for it.

The  other challenge is that with  the reduced  infection,  governments  are committing the money that would have been used for such  interventions on other things. We may soon see a rise in malaria cases  once  the  existing  tools get worn out.

Q. What do you think should be done in order to completely eliminate malaria?

A. Basically, it is a behaviour  change thing. When you have fever, do not start taking pain relievers. You need to seek treatment  because  pain  killers  will only delay the whole treatment process, and it  makes  the disease to manifest in the system.

Another thing is that once people seek treatment,  they  need  to  finish  the dosage to eliminate the parasite completely.

Q. Where do you see the fight  against malaria in the next five years, given the challenges mentioned above?

A. This is the defining moment. It  is either now or never. Sometimes community  members  get  confused when they fall sick. They  are not sure whether it is malaria or something else. The future intervention should therefore  be  based  on  an  integrated approach.

We  also  need  improvement  in  the health systems. For  example  t h e community  health  strategy  has  to ensure that people are visited at  the household level as a way of connecting the last mile. However,  we need to be more  vigilant. Previously  we  had malaria, but now it has gone down. This is more  risky because the conditions are still favourable for the parasite. To be on the safe side, we need to sustain investment  in  malaria  control  and prevention to avoid resurgence.

Q. Do you have any other comment you would like to add?

As KeNAAM, we have realised that we have to move to an integrate d approach, and at the moment we have started  offering  maternal  and  child healthcare  programmes  as  a  new strategy.  We  will  be looking for partners to help us  achieve this. The way  we  have  improved  the  environment for malaria, we need to translate the same to other areas in order to have a bigger impact on the community. You don't want to save a child from malaria,

Twelfth Edition