By: Mercy Chendaeka, Senior Environmental Health Officer and Malaria Elimination Office
Kanchibiya is a rural district in Zambia’s Muchinga province with a total population of 118, 427 according to national statistics. It has 7 health centres, 2 Mini-Hospitals, and 15 health posts. Like in most of the country, malaria is in the top 10 of leading causes of illness and disease in the district which has a very high burden of malaria Incidences, recording around 350 new malaria cases per 1000 population (350/1000) in 2021 alone. This means that Kanchibiya is in the level 3 tier of the malaria stratification guidelines of the National Malaria Elimination Strategic Plan of 2017-2021. This is a marginal improvement compared to 2020 when the district was in the red zone (level 4).
Figure 1: Figure 1:DHIS2 District picture in the past 7 years (situation analysis)
The Partners for a Malaria-Free Zambia (PMFZ) project implemented by Malaria Partners Zambia in the district came to Kanchibiya’s aid in 2021, supporting the districts implementation of malaria preventive and curative measures.
The project, through its partners, supplements government’s efforts in several ways including the training of community health workers, who provide malaria curative and preventive services, health promotion, and the support data management activities in several health facilities across the districts.
Through the support of the PMFZ project, all the health facility catchment areas now have at least one Community Health Worker (CHW) trained in the integrated Community Case Management (iCCM) program. The district has a total of 217 CHWs all trained by Rotary and its partners to test, detect and treat malaria and other ailments at community level.
The presence of trained CHWs has led to an improvement in health seeking behaviour by members of the community and enabled timely access to treatment, having significantly reduced distances to the healthcare. CHWs also contribute to malaria prevention through environmental management activities aimed at clearing breeding sites for mosquitoes.
Rotary, through, Malaria Partners Zambia and World Vision Zambia, has also been very supportive to the district’s health promotion effort sponsoring important commemorations such as World Malaria Day and World Mosquito Day, and community sensitizations through drama performances during outreach services and community meetings.
These health promotion activities have led to an increased uptake of malaria preventive services as evidenced by the acceptance and appreciation, by the community, of services like Indoor Residual Spraying whose coverage this year rose to 106%. The ongoing distribution of Long-Lasting Insecticide Nets (LLINs) to under 5 children and pregnant mothers has also been very well received.
The district was also helped to identify and remedy data quality gaps through malaria Routine Data Quality Audits, co-funded by the PMFZ and PAMO Plus projects, at 10 health facilities. Now malaria prevention strategies will be developed based on accurate and reliable data.
Through partner support, the District Health Office (DHO) has noted the following benefits to the people of Kanchibiya. In particular:
- The training and equipping of influential faith, traditional and civic leaders has helped improve information dissemination on malaria to the communities,
- Trained community health workers have made equitable access to malaria services in the community a reality,
- Social behavior inclined to good malaria preventive practices has improved.
Notwithstanding all the positive strides recorded, the district continues to face some challenges in the fight to eliminate malaria. For example, due to high illiteracy levels in the district, mosquito nets are abused and myths and misconceptions around their use persist. The other thing is that credible, committed and trusted community members who would otherwise be the best community health workers are disqualified by virtual of their inability to read and write.
Operational challenges also exist as the district does not have sufficient transport to deliver and monitor malaria services to full scale. Monitoring and supervisory programs are also hampered by inadequate funds to support such undertakings.
Despite these challenges, the district has still been able to record the good results highlighted above thanks to the collaboration and support of partners such as Rotary through Malaria Partners Zambia, the PAMO Plus project, and the Global Fund. This is in addition to the support provided by government through the provincial and district health offices.
Bio: Mercy Chendaeka is a Senior Environmental Health Officer and Malaria Elimination Officer. She coordinates all malaria programs in her district, Kanchibiya, which is one of the 4 districts that Rotary is supporting in Muchinga province.