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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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INESS - promoting innovation in health delivery

Leading scientist, Dr Hassan Mshinda says the INDEPTH Effectiveness and Safety studies of antimalarials in Africa (INESS) has promoted innovation among African scientists as they endeavour to deliver effective health delivery through Information Communication Technology (ICT). Dr Mshinda was a key stakeholder at the heart of INESS as the first Principal Investigator. Even though he has moved on and is now the Director General of the Tanzania Commission for Science and Technology, Dr. Mshinda has kept an eye on INESS through its many stages. He recently shared his thoughts on the project with the Managing Editor of Eyes on Malaria, Charity Binka.

Q: As the first principal investigator when INESS started in 2009, what do you think is the contribution of INESS to health delivery in Africa?

A: We initiated this project simply because we understood very well that malaria is a major public health problem in our countries particularly in Sub-Saharan Africa. For more than forty years, we have been using monotherapies like chloroquine to treat malaria. The malaria parasite developed resistance to the drug and clearly there was the need to come up with a new solution. This is where the artemisinin-based combination therapies (ACTs) came in. It was also important to see whether the drugs actually worked in our health delivery system. This is the reason why we initiated the INESS Project. I am happy to see the progress that has been made, first of all in terms of the thinking on how one can design studies to be able answer some of those questions.

Q. What are the key components of INESS?

A: The project has a very strong component of strengthening the health system to collect data on adverse drug reactions. The focus is also on strengthening the health system in terms of information.  INESS also uses technology as a tool for information gathering and storage of biometric data. It enables the African scientists to become more innovative in coming up with user-friendly solutions for our setting.

Q: Do you think the use of technology has improved health care delivery in Africa based on the experience of the INESS project?

A:  Technology has a very important role to play in the improvement of the wellbeing of people and economic growth. Africa has remained far behind other countries mainly because it lacked the ability to use technology to advantage. Technology means knowledge. We continue to face health problems simply because we do not use all the available technologies.

Q: Will you say INESS has scored a first in technology use in such a large-scale research?

A: Yes. When you think about INESS in particular, it is the first project to use technology mainly to test ACTs to determine whether they work in real life situations. I remember the challenge we faced when we were thinking of how to identify patients who visit health facilities. Another question we tried to answer was how we can link data.

So technology was actually used first to allow the technology to be delivered in the health system, and secondly to use technology to generate information which is needed. We also used technology in diagnostics. So technology has a very important role to play in the improvement of information that we were generating. It is also important in the improvement of the health delivery system.

Q: Is there any assurance that the information that has been gathered will really be used to improve the system?

A: Yes, so far we researchers have made a substantial progress in data collection and generating information for decision makers. In my position as a broker between policy makers and researchers I can see that we need to put more emphasis on the use of this information in making health policy.  And, researches have an important role to play to make data relevant for use by our development partners and policy makers.

Q: What challenges do you identify in the use of technology in Africa?

A: There are challenges. The major challenge is the unavailability of electricity. Power is not available in many places. In Tanzania for example only two per cent of people in the rural areas use power from the main grid. This means we have to find alternative sources of energy like solar and wind. Another challenge is the lack of information technology (IT) experts in the health sector. The INESS project started without IT experts. They came in later. In my current position I reckon that if we had involved IT experts much earlier they might have come up with different and better solutions. These days, however, a lot of progress is being made in the collection of biometric information and this is becoming routine.

Q: So has INESS been a pacesetter?

A: Yes. When we started the project in Tanzania, nobody was collecting information using biometrics at the district level because only a few people had the expertise. I am sure the scientists coming in now are benefiting from our work and will be better placed in the use of technologies in health delivery.

Q: How successful has this project been?

A: This project has been a very successful one. This project, more than any other, has enabled us to generate ample information on the drugs we are using. It is not easy to gather information on the safety of drugs on a large scale, but the INESS project has been able to do that. Did you know that before INESS we had been generating information on efficacy of drugs only in ideal situations? This one has actually tried to do that in real life. So, these are major successes to me.

Q: Can this initiative be sustained even after the project is over?

A: Yes, I think the most important thing is to sustain these initiatives. In the past information on the safety of drugs are collected on very few people.

It is very important to build within our system the ability to gather information in a short period of time which will help us to know more about the safety of drugs. Obviously, we now know more about ACTs in terms of side effects because of the INESS intervention. We need to sustain the initiative to be able to generate information on the safety and effectiveness of drugs through the effective use of technology.

Q: What is the way forward?

A:  It is very important for both producers of the drugs and public health professionals to work together with the communities to know whether drugs or vaccines work in real life conditions.  That information is important for developing countries like ours where we have limited resources.

- By Charity Binka

Iness Edition