Author Archives: Tim Jesudason

Projects in pictures: Trans-border malaria programme Cambodia

In Cambodia, malaria infection is highest in border regions and among mobile and migrant populations who often live in remote parts of the country, work in forests or travel through endemic areas. The remoteness and mobility of these communities often means they have poor or infrequent access to health care which can lead to malaria cases going undetected and untreated. In other situations, people seeking treatment do so at unregistered private providers, leading to unreported malaria cases and unknown and possibly unsuitable case management practices.

Malaria Consortium’s Trans-border Malaria Programme, in partnership with the Raks Thai Foundation and Population Services Khmer, is strengthening early malaria detection and treatment services and surveillance activities in Thailand and Cambodia.

This programme is being funded by the Global Fund to fight Aids, Tuberculosis and Malaria.

pIn the northern Cambodia Malaria Consortiumnbsphas trained and hired 21 mobile malaria workers to detect hotspots of malaria transmission and to identify people who are at risk of malaria infectionp
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Photos: Luke Duggleby/Malaria Consortium

Mozambique’s unrecognised malaria heroes

Throughout Mozambique’s Niassa Province thousands of unassuming community members have given up their time to improve community health by volunteering in the distribution of long lasting insecticidal nets (LLINs).

 

The campaign, which is distributing over one million LLINs to 480,000 families in April and May is being organised by the Provincial Health Directorate, District and Community Leadership, civil society organisations, World Vision and Malaria Consortium under the leadership of the Provincial Government of Niassa.

So far, over 3,500 men and women from different ages and backgrounds have volunteered in the campaign, which has been crucial to the organisers efforts to reach all families in the province.

 

These malaria heroes have overcome many hurdles including inaccessibility due to lack of roads. They have walked on foot with bundles of nets on their heads and backs where their vehicles could no longer go. They took boats and canoes to reach remote villages on the islands of Lake Niassa. They have used motorcycles, tractors and all possible means to carry out their work, including crossing dangerous areas, such as Niassa Reserve, which is inhabited by many wild animals.

Community volunteers are essential to the success of many health campaigns. See our #MalariaHeroes webpage and support community health volunteers around the world.

The campaign is part of a national initiative led by the Ministry of Health with the support of the Malaria Prevention and Control Project, a project funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and implemented by World Vision as the main partner,  Food for the Hungry, Community Development Foundation and Malaria Consortium.

Strengthening partnerships at the Institutionalising Community Health Conference

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Malaria Consortium Senior Research Advisor Karin Kallander

In March, Malaria Consortium participated in the Institutionalising Community Health Conference (ICHC) in Johannesburg, South Africa. The conference was held to build partnerships and support country-led initiatives to strengthen health systems and community partnerships so that future generations not only survive, but thrive. It also focused on the development of country-specific action plans to address priority issues and challenges.

The global agenda for community health is moving beyond child survival to include the thriving of children so that they can contribute to transformation in their own communities. WHO is in the process of developing guidelines to assist national governments and national and international partners to improve the design, implementation, performance and evaluation of community health worker (CHW) programmes.

Throughout the conference, countries presented their own experiences and lessons learnt on different aspects of implementing community health programmes. Main themes included community engagement, supervision systems, financing of community health programmes, partnerships and engagement with private sector, equity and accountability, and research and innovation including community health information systems.

Malaria Consortium’s Senior Research Advisor, Dr Karin Kallander, contributed to the programme with a presentation on the upSCALE project which uses mobile phone technology (mHealth) to support CHWs in Mozambique. Our Nigeria Country Technical Coordinator, Dr Olusola Oresanya, also presented a poster on the seasonal malaria chemoprevention pilot project in Nigeria.

There was a strong focus on community empowerment throughout the conference and Dr Anthony Costello, WHO Director of Department of Maternal, Newborn, Child and Adolescent Health, outlined the four principles of effective community empowerment during a plenary session. These principles are that it should be country led; scientific (impact at scale is attenuated); have the participation of communities; and include district systems for community empowerment for health – leadership action.

It was acknowledged that participation is not the same as empowerment; participation is to do with outcome yet empowerment is to do with process; empowerment has to do with creating opportunity for people to make options and choices and empowerment is not given but taken.

Equity and gender recommendations included integrating a gender analysis of CHW systems to align policies and programmes to empower CHWs. This included supporting recognition, remuneration and training of CHWs, especially females, to achieve greater gender equity within the CHW system and wider society; and identifying alternative pathways to professionalising CHWs.

The Institutionalising Community Health Conference was hosted by USAID and UNICEF in collaboration with USAID’s flagship Maternal and Child Survival Programme, WHO, and the Bill & Melinda Gates Foundation

Communities embrace new health technology

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moz blog picJosé Petane and Rafael Timóteo Nhone are community health workers from the Cachane community of Inhassoro district, Inhambane province, Mozambique. They provide basic health services to their community of 1,200 people. This includes diagnosing and treating malaria, managing simple cases of pneumonia and diarrhoea, following up with patients seeking care for reproductive health, HIV/AIDS and tuberculosis, and educating the community about health practices.

Last August, José and Rafael received training and began using CommCare, a mobile phone application designed to support community health workers and improve the quality of their services. The system enables community health workers to be in regular contact with their supervisors and the programme’s management.

The CommCare application is not entirely new to Inhambane province. It was developed and tested in a few districts under Malaria Consortium’s inSCALE project (funded by the Bill & Melinda Gates Foundation and UK Aid), which showed positive results in improving the performance and motivation of community health workers.

The roll-out of the project has not been without difficulties however, as José and Rafael explained. “When we first started using phones in our consultations, people did not accept them,” said Rafael. “Many people thought we were doing this only to collect personal data. To overcome this challenge, we called for support from community leaders and organised a community meeting or ‘community dialogue’ to explain the purpose of the phone and answer questions and concerns.”

“After our meetings people realised the value mobile phones have in our services, but this then lead to people only accepting health services if we had a mobile phone,” José added.  “This caused problems when we could not use a phone because of low battery or poor reception, especially on rainy or cloudy days when we can’t recharge the battery on the solar panel. Many people did not understand why we were not using the phone and thought we did not want to treat them or their children. Because of this we now work with both our paper-based registry and a telephone at all times. This shows that what we record on the phone also goes to the book and that we can access information regardless of the situation.”

In this project titled upSCALE, Malaria Consortium, in partnership with Dimagi, UNICEF and the Ministry of Health, with funding from UK Aid, is training all community health workers in Inhambane province to use an improved version of the CommCare system. Community health workers’ have also been equipped with smartphones with bigger and higher quality screens. The project is being supported by the community health committees and community leaders who coordinate community dialogues and help solve problems when they arise. This support and coordination are crucial for the community health workers to be able to provide high quality health services to their communities.

By Dietério Magul

World Malaria Day 2017: Mozambique’s Niassa province launches mass net distribution

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World Malaria Day ceremony, Metangula Village

To mark World Malaria Day on April 25, Niassa province Mozambique held an official launch ceremony for a campaign to distribute long lasting insecticidal nets across the provinces 15 districts. The ceremony was held at the distribution headquarters in Metangula and was attended by district leaders, provincial leaders, civil society organisations and community members.

Activities included the laying of flowers at Heroes’ Square and a march with different civil society players, delivering speeches to spread the message of malaria prevention.

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District administrator Sara Mustafa

The formal distribution of the mosquito nets was initiated by the district administrator, Sara Mustafa, who stressed the importance of using them correctly to a large audience of community members.

Her statements were echoed by Dr. Inês Juleca from the National Malaria Programme of the Ministry of Health, who said, “The distribution campaign needs to be complemented by ongoing mobilisation and awareness raising activities at the local level so it is effective and reduces malaria among the communities the campaign was created to reach.”

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Monica Saíde, mother of five, collecting her mosquito net

Malaria is a major public health issue in Niassa Province, with over 700,000 registered malaria cases in 2016 giving an incidence rate of 407 cases per 1,000 people. The campaign, run by the Ministry of Health and Malaria Consortium, is part of an effort to reduce this burden through wide spread national and local level programmes.

 

The campaign is part of a national initiative led by the Ministry of Health with the support of the Malaria Prevention and Control Project, a project funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and implemented by World Vision as the main partner,  Food for the Hungry, Community Development Foundation and Malaria Consortium.

Text and photos: Xavier Machiana

Recognising community health workers this World Health Day and World Health Worker Week

Mobile malaria worker, Dom Sophat, teaches people at risk of malaria about the disease in O’svay by the Laos/Cambodia border (Photo: Luke Duggleby)

To mark the fourth annual World Health Worker Week as well as World Health Day on Friday 7, this article reflects on global health care and recognises the important work community health workers (CHWs) are doing around the globe.

CHWs play a vital role in extending healthcare to rural communities around the world and are often the first point of call for rural communities who lack access to formal healthcare facilities.

Their responsibilities often include educating people about preventive health measures, caring for pregnant women and new born babies and children under five, as well as diagnosing and treating common infectious diseases and childhood illnesses, such as diarrhoea, pneumonia and malaria.

By providing basic health services at the community level, CHWs also act as a vital link between remote communities and the formal healthcare system. This allows the referral of serious cases to health facilities, ongoing supervision from formal health workers, and improved health reporting.

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Malaria volunteer Ma May Thient Oo

Myanmar: In Sin ‘Elephant’ village, Myanmar, mother of four, Ma May Thient Oo has also been serving her community as a malaria volunteer for the past six years. For the people in Ma’s community, this is an important service. To reach the nearest health centre, they must travel for miles, crossing a river by boat and walking the rest of the way in often extremely high temperatures, which is both expensive and difficult.

To improve health in her community, Ma received training and expanded her services to provide education, diagnoses and treatment, not just for malaria, but also malnutrition, pneumonia and diarrhoea. She can count breathing rates and identify symptoms of common illnesses in her community and only refers people to the health centres when she identifies severe illnesses that she cannot treat.

Village malaria worker Thy Sambath (Photo: Luke Duggleby)

Cambodia:  In Tun Village in northern Cambodia, village malaria worker, Thy Sambath, provides free malaria education, testing and treatment to people in his community. He is a volunteer that wants to improve the health of his people, particularly those who live, work or travel in forest areas and have the highest risk of malaria.

Thy visited the Sreynoeunn family after learning both daughters, aged four and 11, had developed strong fevers. He conducted malaria tests on the girls which both turned out to be positive. Thy then provided the girls with treatment and educated the family about the importance of using mosquito nets while sleeping. Thanks to Thy both girls made full recoveries.

Village Health Team member Ali Karim Bagyanyi

Uganda:  Ali Karim Bagyanyi is a Village Health Team member in Kitengule village in Uganda. In this role he provides education as well as free testing for malaria and pneumonia.

In a recent visit, Ali tested a 17 month old girl and four year old boy who had been brought there after developing diarrhoea, fevers and a cough. Both children tested negative for malaria and pneumonia and received appropriate referrals to be treated for their diarrhoea.

It is estimated that half of the nine million children who died in 2015 had illnesses that could have been easily prevented, or diagnosed and treated if they had access to health care services. However, there is currently a global shortage of over seven million health workers and that shortage is set to rise to almost 13 million by 2035. If we are to achieve universal health coverage we must increase investment in community health workers. This World Health Worker Week and World Health Day, join us in supporting health workers around the world.

Watch our video here: 

Voices for better health: Mozambique

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A large scale long lasting insecticide-treated net (LLIN) campaign was officially launched by President Filipe Jacinto Nyusi in November last year in an effort to reduce malaria in Mozambique. Many Mozambicans are still falling ill or dying of malaria. In 2014 alone, over five million cases of the disease were diagnosed, leading to over 3000 deaths.

The mass LLIN distribution campaign, supported by Malaria Consortium, is providing over 13 million nets across the country, with the first stage distribution taking place in Nampula and Niassa provinces. We spoke with some of the people involved in the first stage of the distribution to find out how the programme was being received by local communities.

Azelio Fulede MCD Ilha de Mocambique (4)Azélio Fulede, Chief Medical Officer

“The health situation in our district was critical because communities didn’t know how to use mosquito nets. Now, through social mobilisation activities run by community leaders, activists, volunteers, and community radio we are seeing behaviour change and the nets are being used properly.

In our regular visits to the communities, we see that families now hang the nets over their beds, on the porch or wherever they sleep. When we meet people who do not know how to hang the nets, we show them and help them. These are encouraging changes; fewer people are getting malaria and positive messages continue to spread within communities. We hope that fewer people will fall ill and that we will eventually eliminate the disease.”

Emília Corela, cEmiliaampaign supervisor

“I can already see changes in peoples’ behaviour. Everywhere you go you can see mosquito nets being aired in the shade, hanging on the balconies and in bedrooms. These are new scenes, really – you would not have seen this before. I believe that the efforts we made to educate the population about the importance of using nets to protect themselves and their families against malaria, such as advocacy events, lectures in schools, information sessions at community level, are beginning to bear fruit.

On a personal level my involvement in this undertaking has been very rewarding. I gained work experience, lost my shyness, learned more about interacting with people and meeting new people; these skills will also help improve my work.”

Nare Luis PF Erati (3)Naré Luis, focal point for malaria in the Eráti district

“This LLIN distribution campaign was a major challenge for us because it was the first time we covered the entire district, providing nets to over 95 percent of the population.

Malaria is a major health problem in the Eráti district, affecting as many as 60 percent of our people. However through this campaign we are already seeing that there is less malaria. We are now working together with the community health workers, local leaders and radios stations to ensure people know how to use and keep the nets in good condition.”

Francisco Eduardo APE (10)Francisco Eduardo, volunteer community health worker in Mucuegera

“Eighty percent of my work is devoted to community health promotion activities, including village health talks to ensure our community understands how to prevent diseases such as cholera, diarrhoea and malaria. The other 20 percent of my time I provide treatment services at either my patients’ homes or my own home.

The net distribution has been an excellent opportunity to show people the correct use of a mosquito net. I notice the difference in my daily home visits. People are hanging the nets and sleeping under them and I have already seen that malaria is reducing! Last year during the rainy season I diagnosed more than 100 malaria cases in only one month, but this year I recorded only 39.

Marcelino Joao MCD Nacala Porto (2)Marcelino Joao, Chief Medical Officer, Nacala Porto district

“Investing in mosquito nets is a guarantee for a long life! Before the distribution campaign, people often used nets for fishing and not for sleeping under. Malaria Consortium trained people from civil society associations and community structures, as well as community health workers, to help mobilise these communities, raise awareness and change behaviour in relation to malaria prevention and the appropriate use and care of mosquito nets. These messages have been reinforced by local radio and television channels which broadcasted the messages intensively during the campaign.

Through these efforts, we have already recorded a decrease in cases of malaria. We are very satisfied with the results and we believe quality of life will improve in the district. We will continue to hold regular meetings with local community leaders and to spread correct information about malaria prevention and the appropriate use of mosquito nets.”

Marcelino Melo PF DPSMarcelino de Melo, Provincial Health Directorate of Nampula province

“For the first time we have managed to distribute LLINs to all districts in the province – reaching a total of 1.3 million families with over 3.5 million mosquito nets. We are now focused on strengthening communication via radio, television, posters and leaflets so that people make good use of the nets we distributed.”

LLIN distributions are a key component in the Malaria Prevention and Control project, a country-wide initiative funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and implemented by World Vision as primary partner, Malaria Consortium, Food for the Hungry (FH) and Foundation for Community Development (FDC).

By Dorca Nhaca, Malaria Consortium, Nampula office, Mozambique

Top five moments of 2016

At Malaria Consortium we continued to work towards achieving our mission throughout 2016. With the support of our donors, partners and collaborators, we helped to improve lives in Africa and Asia through sustainable, evidence-based programmes that combat targeted diseases and promote child and maternal health. See below for a few of our highlights of 2016.

1) 6.4 million children receive seasonal malaria chemoprevention

Access smc

We continued to transform the malaria landscape in the Sahel through our ACCESS-SMC project that administers seasonal malaria chemoprevention. Funded by UNITAID, ACCESS-SMC treated approximately 6.4 million children during the 2016 campaign, including 88 percent of children under five years old.

 

2) Transforming Nigeria’s health sector 

Long lasting insecticide net demonstration

Long lasting insecticide net demonstration

The Department for International Development funded ‘Support to National Malaria Programme’ or SuNMaP concluded in 2016. This ground breaking eight-year project, led by Malaria Consortium, took an innovative approach to strengthening the country’s management of malaria at both state and federal level, harmonising intervention efforts and vastly improving demand for and access to malaria services. In addition, the project delivered millions of nets and has already saved an estimated 48,000 lives, which would have been lost to malaria.

3) Malaria Consortium placed as top GiveWell charity

GW_Logo_Standard_300ppi_CMYK (7) Malaria Consortium was selected as a GiveWell top recommended charity for our expertise in delivering seasonal malaria chemoprevention (SMC). GiveWell is a world-renowned meta-NGO that recommends charities by assessing them on four criteria: effectiveness, cost-effectiveness, transparency, and room for more funding.

 

4) New innovations in the fight against dengue and malaria 

Guppy fish eating mosquito larvae_During an experiment at the press chat

Guppy fish eating mosquito larvae during a presentation in Phnom Penh

We continued to develop and deliver innovative approaches to disease control in 2016. Most notably, our integrated vector management project, which uses larvae-eating guppy fish to reduce mosquito populations, was successful in reducing potentially dengue-carrying mosquito rates by 46 percent in Cambodia’s high risk areas. The project received wide spread recognition for being cost effective, sustainable and easy to implement, making it a suitable intervention for scale up.

In Myanmar, Malaria Consortium established an insecticide-treated clothing (ITC) project to determine the acceptability of ITC for malaria prevention among the key risk groups at the community level, such as rubber tappers. It was the first time this research had been conducted at the community level. Results showed that ITC was easy to use, durable, reduced mosquito bites and also has the potential for scale up.

5) 2016 World Malaria Report 

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Secretary of State for International Development, Priti Patel, at the World Malaria Report launch

Malaria Consortium supported the launch of The World Health Organization’s annual World Malaria Report in the UK at an event co-organised with Malaria No More UK, the All-Party Parliamentary Group for Malaria and Neglected Tropical Diseases, and other leading malaria NGOs. The report contained a range of achievements and detailed the progress made towards achieving the 2030 Sustainable Development Goals. These included a five-fold increase in the recommended three or more doses of preventive treatment for pregnant women and an 80 percent increase in the use of long-lasting insecticidal mosquito nets for all populations at risk of malaria.

At the report launch, the UK’s International Development Secretary, Priti Patel, reiterated the UK’s commitment to end malaria and announced an additional £75 million investment to support the development of antimalarial drugs and insecticides.

We look forward to continuing to work with all of our partners and donors throughout 2017 to improve lives and progress towards achieving the 2030 Sustainable Development Goals. 

 

 

Uncovering Asian tropical medicine – JITMM 2016

By Kyaw Thura Tun

jitmmThe Joint International Tropical Medicine Meeting 2016 (JITMM) took place this December with the theme ‘Uncover Asian tropical medicine’. The event was a great success, attracting over 800 regional and international participants, the highest attendance in over a decade.

During the conference Malaria Consortium staff presented the organisation’s expertise in innovative research, dengue and surveillance, outlined current regional projects and chaired group sessions.

Notable events included Malaria Consortium Asia Director Siddhi Aryal chairing the session ‘Meeting the challenge of outdoor transmission of malaria’. The session was extremely informative and featured presentations from World Health Organization (WHO) Emergency Response to Artemisinin Resistance Hub, Institute of Tropical Medicine of Antwerp Belgium and Infakara Health Institute of Tanzania. The WHO Emergency Response to Artemisinin Resistance Hub presentation by Michael MacDonald was a particular standout as he explained new paradigms for outdoor malaria transmission control, which showed options and opportunities moving from concept to programme implementation in the contexts of the Greater Mekong Sub-region. 

jitmm-2Other Malaria Consortium presentations included Vanney Keo and Dyna Doum’s dengue related presentations about the situation in Cambodia and Shafique Muhammad’s session entitled ‘Malaria elimination: Mobile populations and behaviour changes’. This session – with presentations from Malaria Consortium, Bureau of Vector Borne Disease of Thailand and Raks Thai Foundation – attracted an array of stakeholders and partners with an interest in more effective and regional behaviour changes among mobile populations.

On the final day of the conference, I presented ‘Improved surveillance towards malaria elimination in Myanmar’. The presentation detailed how the National Malaria Control Programme project, supported by Malaria Consortium, filled gaps in capacity and surveillance, and how data gathering and data accessibility has improved greatly. In particular, I explained why our approach and the consolidation of data at all levels, including townships, states and regional levels, is so appropriate to Myanmar.

jitmm-3JITMM is the most notable annual event for the tropical medicine community in Asia, bringing a wide range of researchers, scientists, lecturers, programme managers, implementers, students, donors and policy makers from around the world. This meeting was one of the opportunities for Malaria Consortium to present our work to the region and the world. I was glad to see such a great turn out and high quality presentations, not just from Malaria Consortium staff, but the whole community. I look forward to returning in 2017.

Meet the recipients of Mozambique’s largest ever mosquito net distribution

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By Dorca Nhaca

On 3rd November 2016 the Ministry of Health, Mozambique, launched the largest ever distribution of mosquito nets. In total over 13 million long lasting insecticide-treated nets (LLIN) will be distributed throughout the country – an important step to reducing the burden of malaria.

Malaria Consortium has supported the roll out of this mass distribution in the most populous province of the country, Nampula, located in the north of the country, delivering LLINs to protect over five million people.

As a consultant on the project, I travelled the Nampula province monitoring and supporting distribution efforts. The importance of this project was clear during my visits to various districts. Everywhere I went people converged en masse to the distribution points and were eager to get mosquito nets to protect their families.

I managed to speak with some of the recipients about the project and what it means for their families. This is what they told me:

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Mrs Gracinda Francisco, Monapo district

“Today I received two mosquito nets and I am very happy because my family will be protected from mosquito bites. The mosquito causes malaria which is a disease that makes us very weak. Before receiving these nets, the situation was very complicated in our home because we only had one old net to share with our son. The net was old and damaged and the mosquitos could easily enter through the holes. We had a terrible time because our home is close to the Monapo River which brings a lot of mosquitoes. People are constantly sick. Last month, my son fell ill and had to be admitted in hospital for treatment. I was worried because he is still very small. He is doing better now and these nets will help a lot to prevent malaria in my family.”

calima-primeiro-1Calima Primeiro, Rapale district
“I am very happy to have received these nets. It will greatly improve malaria care at home. The people in my neighborhood have suffered a lot from malaria and we have also suffered from this disease in our home. We had not used mosquito nets for a long time. A few weeks ago, I myself got malaria and I was very resentful because I was very weak and could not walk or work on the farm. We are currently in the agricultural season where we sow corn, peanuts and other crops, so my sickness caused a difficult situation. The children who live with me could not go to the farm because they had to take care of me. I had to stay home and could not do anything for about eight days. After this, my daughter and grand-daughter became sick with malaria and I had to take them to the hospital for treatment. This was a big learning experience for me: we got sick because we did not protect ourselves.

The government came at the right time to help us fight this disease. I know that malaria is dangerous and a killer disease. Now, if we use the mosquito net we can not only avoid getting sick, but also avoid spending money for the medicines and use this money for other things. So, I and my family will use the mosquito nets so we don’t get bitten by mosquitoes.”

valentim-antonio-cidade-nampula-2Valentim Daniel António, Nampula City
“I started using a mosquito net in 2010 when my wife became sick with malaria. At the time, she was pregnant. Besides not having the financial means to buy a mosquito net, we did not realise the importance of nets, because we thought that if we got sick we could just go to the hospital and get treated. But this time it was different. My wife was so sick that she had to be admitted to hospital while she was pregnant; she became very weak and had to take intravenous drugs. Luckily my wife got better and when she left the hospital, the nurse who cared for her asked us if we had a net at home and we said no. She gave a net to my wife and advised us to always use the net because malaria can be deadly. When we got home, we started using the net, but my kids did not because we had only one.

I bought two more nets for my children and nephews but after several years they developed holes and I could not replace them, but today, I received three new nets, and I want to thank the government.

I say with great pride that I use the mosquito net to protect my family’s health against malaria. If this net gets spoiled, then I will buy replacements. I am pleased to be a part of those benefiting from mosquito nets and I have been mobilising my family, friends and neighbors to use the mosquito net because it protects us from the mosquito bite that causes malaria – it is really worth it.”

pTrucks loaded with nets are sent to distribution centres around Nampulap
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Dorca Nhaca is a consultant to Malaria Consortium in its Nampula Office, Mozambique

This undertaking is part of a nation-wide initiative lead by the Ministry of Health with support from the Malaria Prevention and Control project, a country-wide initiative funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and implemented by World Vision as primary partner, Malaria Consortium, Food for the Hungry (FH) and Foundation for Community Development (FDC).