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.
Analysts say if countries on the continent emulated Zambia's example and avoided certain shortcomings, eradication of malaria would not appear too distant a reality.
In a demonstration of how good policies and partnerships help achieve results, Zambia has ensured that 73% of households owned either one or more insecticide treated nets (ITNs) or had received indoor residual spraying (IRS) in the past 12 months.The Roll Back Malaria (RBM) Progress and Impact reports show that parasitaemia, anaemia, and child mortality have all decreased. And the number of children's lives saved by malaria control measures is estimated to be at least 33 000 over the last 10 years.
Seventy per cent of pregnant women received at least two doses of sulfadoxine-pyrimethamine during ante-natal medical consultations in 2010—compared with 53% in 2004.
Zambia expanded microscopy training, rapid diagnostic test (RDT) use and availability of artemisinin-based combination therapies (ACTs) in health facilities, and extended the use of community health workers trained in malaria diagnosis and treatment.
Following an intense training in 2008, all of the country's health centres have been using RDTs provided free of charge to diagnose malaria. Approximately two million RDTs are distributed yearly for better diagnosis of malaria. With the intensification of preventive measures and the wider use of RDTs, the number of ACT treatments required should decrease, resulting in significant cost savings.
When the government heard of continuous shortages of essential medicines at service delivery points (SDPs) throughout the country, it responded by initiating a logistics system
pilot project to improve the availability of key essential medicines with funding and support from the United States Government and the World Bank.
Drug availability has improved tremendously, particularly for antimalarial drugs and antibiotics”, said Oscar Bwalya, pharmacy technician at Mungwi Rural Health Centre.
“We have the ability to do a physical count and order according to demand. This has ensured access to a variety of medicines by our community.”
Community health workers were taught by media experts how to inform the population about malaria prevention and control, and sensitization of
Key messages and IEC materials were developed through a national programme that engaged community leaders as messengers.
Religious leaders were trained in malaria control in each province. The 27 chiefs comprising the House of Chiefs—the body that represents Zambia's many traditional leaders— were similarly oriented.
In 2011, the Zambian National Malaria Control Centre (NMCC) conducted nationwide provincial-level training for civil leaders—district commissioners, ward councillors, mayors and town clerks.
Today, Zambia is mentioned among the countries leading in the fight against malaria, due to the methodical approach to confronting malaria, the continent's biggest killer, by the horn. It is on course to control the deleterious effects of malaria which accounts for 40% of outpatient attendance, 40% infant mortality and nearly 20% of deaths in children below five years.
The Zambian political leadership claims much credit for making the Health and the Finance Ministry collaborate in driving the malaria-control effort. The President himself has been seen repeatedly wearing malaria-control T-shirts and has had his own house sprayed as a gesture to encourage the citizens.
In Zambia, IRS is conducted as an annual event, between the months of September and December, just before the peak malaria transmission period.
The health budget allocation has recently increased by 30% and so have the grants to the districts where most of the activities are taking place.
Worthy of mention is the partnership of public and private stakeholders (academia, faith-based institutions, media etc.) which made this possible.
The private sector in Zambia has been most proactive and played a significant role by investing heavily in malaria control. Zambia Sugar, Mopani Copper Mines Plc. (MCM) and Konkola Copper Mines Plc. (KCM) have been known to lead in this area, allocating about 70% of the companies' malaria budget to IRS. This complemented the work by the public sector that supported the distribution of bed nets in the affected districts.
The reduction in malaria cases recorded in the company health facilities eclipse the already impressive reductions (approximately 60% decreases) recorded in public facilities across Zambia in recent years.
Between 2000 and 2009, the recorded malaria cases in company clinics decreased by 94%. The number of malaria-related lost work days decreased by the same amount and
malaria-related spending at company clinics decreased by 76%. More than 300 lives were saved through the malaria-prevention activities of these companies alone.
The Health Ministry encouraged stakeholder participation and co-rdinated joint-planning sessions which ensured the implementation of the strategic plan with the support of all.
The community was encouraged to own the process and take leadership of malaria control programmes. This community engagement brought in traditional and religious leaders as well as ward councillors to lead the fight against malaria at the community level.
The increasing reliance on community health workers (CHWs) to implement i n t e r ve n t i o n s i n t h e Z a m b i a n communities has proven to be just as vital as having volunteers within the community carry out IRS and mosquito-net distributions.
Dr Victor Mukonka, Director of Public Health at the Ministry of Health in Zambia explains that care was taken to avoid parallel programmes. All activities had to be co-ordinated under the umbrella of the Ministry of Health. It required vigilance.
Countries seeking to emulate the Zambian example need to decentralize and empower the communities at the district level. That country at some point bypassed provincial health authorities who are supposed to be the main link between the central and local levels. By strengthening the districts Zambia managed to reach the communities with ease, and it helped.
“It is a great strategy to empower the community leaders to be proactive and also make sure all actions are coordinated by the local health authorities if we are aiming for sustainability. I see two main ways of doing this. The first way is to re-establish departments of public healt within local authorities. The second is to allocate more resources to health authorities to allow them to play an effective coordinating role. Seconding public-health staff to provincial and local levels would serve the same purpose” says Dr Mukonka.
Thus Zambia's progress in malaria control has not only been remarkable but confirms that good malaria interventions bring positive results.
Between 2005 and 2010, efforts have intensified markedly, resulting in a massive scale-up of interventions to both prevent and treat the disease. Rural and poor populations can now be reached as well or even better than urban and wealthier ones.
Staying on course This feat was made possible partly through the external funding of nearly US$ 200 million between 2003 and 2010, which enabled Zambia's National Malaria Control Programme to deliver malaria control and prevention interventions to urban and rural households.
And experts warn that unless this momentum, partnership and funding levels are increased or at least maintained, this success remains fragile.
This is evident in the fact that after a marked nationwide reduction between 2006 and 2008, malaria parasite prevalence increased in the north-eastern area of Zambia between 2008 and 2010. It was blamed on funding restrictions in 2009 and 2010 which led to the decreases in coverage of malaria-control interventions in the affected areas.
This was a difficult learning curve for Zambians who have resolved henceforth to rely on predictable and sufficient funding to roll out the effective interventions.
Short of that, malaria will swiftly hit back and people will suffer. And that is a lesson not only for Zambia but all malaria-endemic countries on the continent.
Roll Back Malaria (RBM) Progress and