Category Archives: Projects

The time to invest is now: fighting malaria in the Sahel

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Children in sub-Saharan Africa are 14 times more likely to die before the age of five than those living elsewhere in the world. Preventable and treatable diseases, such as malaria, claim hundreds of thousands of lives each year.

Since 2014, leading players in malaria prevention have come together to deliver seasonal malaria chemoprevention (SMC) to children under five in the Sahel. SMC – a World Health Organization recommended intervention – is an antimalarial medicine given to children each month for up to four months of the rainy season, when 60 percent of malaria cases occur. It provides a high degree of protection, with about 90 percent efficacy and has the potential to reduce cases of malaria by 75 percent.

After concentrated efforts from the UNITAID funded ACCESS-SMC project, led by Malaria Consortium in partnership with Catholic Relief Services, and other organisations’ SMC programmes, roughly 12 million children received SMC in 2016. Over 6.4 million of those children were reached through ACCESS-SMC across seven countries[1].

Many children will still miss out on receiving SMC in 2017 though, due to lack of funding and production capacity for quality assured medicines used in SMC (SP+AQ). Nine million children in Nigeria alone, will remain unprotected this rainy season.

With areas in the Sahel having the highest incidence of malaria in the world, it is time to look towards reaching all 25 million eligible children. For less than $5, one child is protected with SMC each year. To support our continued efforts as a GiveWell Top Charity protecting all 25 million children in the Sahel from malaria visit http://www.givewell.org/charities/malaria-consortium.

 

[1] Burkina Faso, Chad, Guinea, Mali, Niger, Nigeria, The Gambia

Delivering nets at the last mile: success through promoting a culture of net use

In February and March 2017, USAID’s Malaria Action Program for Districts distributed one million long-lasting insecticidal nets to 1,978,114 people in three districts in Uganda. A focus on promoting positive behavior change on net use led to the successful delivery of the campaign.

Background

In the three districts of Arua, Koboko and Nebbi in West Nile region, malaria, like in most parts of Uganda, is a serious public health problem. In these three disctrict, which has a population of over 1.5 million, over 700,000 confirmed or suspected malaria cases were reported to public health facilities in 2016.  
USAID’s Malaria Action Program for Districts conducted a long-lasting insecticidal net (LLIN) distribution campaign in February and March 2017 as part of its objectives to increase the impact and reach of malaria prevention services. The project took a four-step approach in conducting the LLIN distribution campaign: 1) community sensitization 2) a community-led registration of households, 3) data-entry and verification, and 4) community-led distribution. During community sensitization, emphasis was placed on social behavior change communication (SBCC) to reach all targeted communities with relevant and effective messages on use of LLINs.

Promoting a Culture of Net Use

Prior to household registration, the project team convened a regional advocacy meeting in Arua district with local leaders from the three districts. These included district health officers, resident district commissioners, district health team, chief administrative officers and local council V chairpersons. Local leaders’ understanding of malaria prevention and their engagement in promoting positive behavior towards malaria prevention was key to the campaign’s success.
During this meeting, the project team shared malaria prevention strategies and messages to the local leaders who would then share these with their own communities.
The leaders committed to promoting a culture of net use, highlighting that a significant change in mindset and behavior towards prevention can lead to a ‘malaria-free world’. They shared a vision of a malaria-free district – where communities would have higher levels of productivity, due to less money lost on treating malaria and more time spent on income-generating activities. Leaders also raised the need for adequate community-led mobilization for household registration and subsequent LLINs collection, as well as working with the local wanaichi to create a net use culture.

Successes and Impact

The high turnout of community members can be attributed to effective community-led mobilization and the malaria messages that promoted positive prevention behaviors such as net use. In Nebbi district, for example, leaders indicated that sensitizing the community before the distribution was key to its success:

“… you will realise on the day of distribution that there is going to be high turnout of community members […] this has been shown in registration after the community’s sensitisation by political leaders and other stakeholders. When you look at the registration, you feel very happy that these people have been sensitised. The registration was 100 percent. Everybody registered because they understood why the nets are being distributed to them. So this has been a very big achievement.”
– Olweku Fred Jibril, Secretary for Social Services, Nebbi district

The campaign in the three districts reached 98 percent of households registered during the pre-campaign registration. At the wave one review meeting, district supervisors in the three West Nile districts reported that 91 percent of the population was sleeping under a net.

The net distribution campaign was welcomed by the community members and health workers alike:

“…On behalf of my people, we are very happy for this service, in fact, we have been having problems of malaria [for a long time], and case numbers had become so high that we could not manage with the current drugs in the hospitals. So I think with this, it is going to improve our health.”
– Achong Emmanuel, area LCI Oufa Village, Aiivu sub county

“The reason I have come for the net is because we have so many mosquitoes and there is a high rate of malaria, as we are along the river. The mosquitoes are very many. Without nets, there is no sleep here…”
– Net recipient, Rhino Camp

Lessons and Next Steps

Community involvement is instrumental in ensuring a well-supported distribution and to achieve a high proportion of immediate net uptake and sustained use of nets. An SBCC approach before the net distribution campaign allowed community leaders and members to be engaged in education around malaria prevention.
Building on these successes, USAID’s Malaria Action Program for Districts will continue to run an SBCC campaign to create a culture of net use through a community-led approach for promoting the correct and consistent use of nets which is supported by local council leaders.

Download the Success Story in PDF format here.

Chimbonila: A district committed to fighting malaria

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The district of Chimbonila in Niassa province has a high malaria burden, which can be difficult to manage for a number of reasons.

The district itself is very large. It is located about 30 km from the city of Lichinga and covers an area of ​​8,075 km² with a population of about 87,000 inhabitants. Despite its proximity to the capital city, however, Chimbonila has the typical challenges of the other districts of Niassa: poor roads and high poverty rates, as well as a remote, mostly rural population which relies on an economy based on agriculture (population density of 15.8 inhabitants per km²).

Since 2014, the National Malaria Control Programme of the Ministry of Health and its partners (World Vision and Malaria Consortium) with funding from the Global Fund, has been implementing the Malaria Prevention and Control Project within local communities.

The project in Chimbonila District involves 22 community structures, 428 volunteers, 23 schools, 72 teachers, 14 health facilities and one community radio in a continuous effort coordinated by Health, Women and Social District Services to ensure the prevention and treatment of malaria.

Since 2014, Gabriela Nazaré has been the Malaria Consortium Field Officer assigned to this district. Her role is to coordinate the activities of all project stakeholders, ranging from health facilities to community volunteers.

Every day Gabriela visits the villages by motorcycle, ensuring that all project’s participants have the necessary tools for mobilisation work and that they have a correct understanding about how to prevent malaria and that they know what to do in the occurrence of malaria symptoms.

After three years as Field Officer, Gabriela feels integrated in the community: “I was born and raised in Lichinga. I moved to Chimbonila to work and today I feel at home. Despite the complexity of the job, knowing that I am contributing to the improvement of people’s living conditions is rewarding.”

Rain or shine, her activities don’t stop. Owing to the large number of beneficiaries, her schedule is very busy. “I try to spend as much time as possible in each community. My routine in each village is to visit schools, health facilities and work with community structures.

“Over the years we have been establishing work mechanisms and today it is amazing how communities are engaged in the project in such a way that they now bring in their own initiatives and suggestions for new approaches.”

 

Text and photos: Xavier Machiana

Distribution of LLINs in Niassa Province: mission accomplished

After a year of intensive work, Niassa Province in Mozambique, an area with a high malaria incidence rate, has successfully completed its mass long-lasting insecticidal net (LLIN) distribution campaign in its 16 districts.

The Malaria Prevention and Control Project is part of the Universal Coverage Campaign (UCC),  a national initiative led by the Ministry of Health.  It is funded by the Global Fund, and implemented by World Vision as the recipient partner, with Malaria Consortium, Food for the Hungry and Community Development Foundation as secondary recipients.

The UCC aims to ensure that every Mozambican has access to a LLIN to protect themselves from malaria. In Niassa Province, the campaign has reached approximately 415,000 households in the 16 target districts, amounting to a total of 1,058,750 LLINs. Niassa Province covers an extensive area of ​​approximately 123,000 km², with around nine inhabitants per km² in some of the more remote areas.  Access roads are lacking and most are not tarred, which renders the UCC implementation a complex process.

To overcome these challenges and to meet the high demand, the campaign was cascaded down from the central level, on to the provincial level, and finally expanded to the districts, towns and villages. In a combined effort of thousands of people involved.  The local government, the Provincial Health Directorate, District Directorates, support teams, trainers, distributors, registrators and different service providers were all critical to the success of the mass distribution.

According to Dr. Inês Juleca, focal point of the National Malaria Control Programme of the Ministry of Health of Mozambique for the province of Niassa, “The distribution of LLINs is an activity that includes several steps and high-quality coordination, from the consultation of guiding documents, planning, procurement, transportation and packaging, to communication, engagement, mobilisation, training, population registration and distribution itself.”

In this process, the National Malaria Control Programme is responsible for the acquisition of LLINs and led overall planning and implementation through the decentralised structures of the health system. Malaria Consortium is responsible for operational support, which includes financial management, transport, logistics, training, management of service providers, efficient use of resources and effective coordination at provincial, district and field levels.

On the challenges encountered on the ground, Joaquim Chau, Interim Coordinator of the Malaria Consortium in Niassa province, says: “The challenge of coordinating processes is largely to achieve the commitment of all those involved, even with different procedures or practices, sensitivities and institutional hierarchies, to bring together an understanding of the common vision of what is to be achieved. This makes a difference in the process, and in the professional and individual expectations of all the actors involved.”

With the successful completion of the distribution, the team is planning a post-distribution campaign that will focus on effective messaging about the correct use of LLINs. Highlighting the importance of the post-distribution campaign, Dr. Juleca stated: “Malaria prevention does not end with distribution of mosquito nets. We are ensuring that, after the distribution phase, our beneficiaries are knowledgeable about the use of nets and that this process is effectively translated into behaviour change.”

By Xavier Machiana

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.

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

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

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).

Exciting times for new pneumonia diagnostic tools

kevin-photo2This year’s ASTMH saw a number of key sessions and presentations that highlighted the exciting work being done to evaluate the performance of new pneumonia diagnostic aids at the community level.

Day one included a presentation by Dr. Michael Hawkes from the University of Alberta titled: ‘Solar powered oxygen delivery: a randomized controlled non-inferiority trial’. The presentation provided evidence for to show solar powered oxygen delivery can be an effective intervention in resource poor settings. The study was conducted in Jinja, Uganda and based on the results the project team is now planning to expand the work to another 85 health facilities in Uganda.

This was followed by Save the Children’s evaluation of the Philips ChARM device (Children’s Automated Respiratory Monitor) – an innovative and easy to use pneumonia-screening tool for low resource settings. The evaluation showed that the ChARM device is an acceptable alternate diagnostic tool for identifying fast breathing among children under five. 

On day two, Malaria Consortium’s US Representative, Madeleine Marasciulo, moderated a symposium titled ‘Key elements for improving management of pneumonia in children in resource poor settings’. The symposium was attended by over 200 people.

The event featured a presentation from Malaria Consortium’s African Technical Advisor, Dr Ebenezer Baba, ‘Progress towards universal access to pneumonia treatment’, as well as results from the pneumonia diagnostics study, presented by Pneumonia Diagnostics Programme Coordinator, Kevin Baker. The results highlighted the difficulty health workers face when counting respiratory rates and the need for better tools to support them to better detect the symptoms of pneumonia.

Following this, Kristoffer Gandrup-Marino, Chief ofInnovation at UNICEF Supply Division presented plans for the ARIDA project and the important factors to consider when developing pneumonia diagnostic trials at the community level in resource poor settings.
If the pneumonia diagnostics project showed us anything, it is the urgent need for user-friendly devices and for technological innovators to continue developing diagnostic tools for the millions of health workers who use them to count respiratory rates every day. The ARIDA trial is taking this forward, Kevin Baker said.

Finally, Dr Grant Aaron, Global Health Director at Masimo, presented ‘Scaling up Medical Oxygen and Pulse Oximetry – the case of Ethiopia’. Dr. Aaron highlighted the work being done to scale up oxygen management in Ethiopia as well as a new respiratory rate device being developed by Masimo.

On Tuesday evening an important session was held on the Pneumonia Etiology Research for Child Health Study (PERCH). PERCH is a multi-country, comprehensive evaluation of the etiologic agents causing severe and very severe pneumonia among children 28 days to 59 months with data collected between August 2011 and January 2014, with over 9,500 cases enrolled.

It was great to see such high quality sessions on pneumonia at ASTMH this year with several of the sessions presenting important findings for the first time. Community health delivery in remote or low resource settings will surely benefit from the new diagnostic tools and study results.

By Kevin Baker

pPanel photo from the pneumonia symposiump
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Before, we had no way to prevent malaria. Now the nets protect the whole family

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It’s the second week of August in Lichinga, Niassa Province in northern Mozambique – not far from the Malawi and Tanzania borders. It is a cold and wintery month with grey skies.

After about two months of preparation, our mosquito net distribution campaign using long lasting insecticide treated nets (LLINS) for universal coverage has finally reached the distribution stage. The teams who have been working to support and supervise the campaign will set out for the Ngaúma, Mandimba, Metarica, Nipepe, Marrupa and Majune districts – the six included in the first stage of distribution. Expectations are high for everyone involved. Finally, the campaign will start.

The main ceremonies of the campaign’s launch will take place in the Chimbunila district village of Lumbi, 15 km from the city of Lichinga. Here, in addition to the distribution of LLINs, a new health facility will be opened.

Alifa Rachide’s family was chosen by the community to receive the first LLINs to be distributed in this province. Alifa, 50, will bring his wife Atuege Jemuce, 43, and their seven children to the event. Their daughter attends fourth grade and another child is in year one. Alifa doesn’t know the exact age of his children, but he says the youngest is less than a year old.

The couple, originally from Lumbi, support themselves by cultivating cassava, groundnuts and beans, ensuring a supply of food for the family and generating some extra income. Alifa says this is the first time that his family will receive mosquito nets. “We never had mosquito nets, and so we had no way to prevent the mosquito bites and malaria,” he said. “At home, someone gets sick with malaria most years, but fortunately this year no one has got sick yet. I’m happy because the nets we receive will protect the family from malaria.”

Alifa and his family received four LLINs – a sufficient number to cover the whole family, since two people can usually sleep under a single net. His wife Atuege lets out a smile because the community will have a closer health facility that will reduce the distance they have to walk – involving crossing a river and the risk of crocodile attacks. She says: “Our family was chosen by God – we have received mosquito nets, and we have a health facility. Community leaders visited our house and informed us that we would receive LLINs at a ceremony held by the Government. And here we are.”

The LLIN distribution campaign was implemented by Malaria Consortium, under a project funded by the Global Fund Round 9. The project is being carried out in nine provinces of Mozambique, partnering with World Vision and the Foundation for Community Development (FDC). Malaria Consortium supported the Provincial Health Directorates of Niassa and Nampula to distribute around 1,000,000 LLINs, benefiting more than 400,000 families. In addition to distributing LLINs, the project involves training volunteers and teachers to educate and engage their communities around malaria prevention and control strategies.

Fernando Bambo is Deputy Project Manager in Mozambique