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Bridging gaps in malaria control in northern Uganda

Situation:

Nearly two decades of conflict in Uganda have displaced up to two million people, of whom 90% are still living in IDP camps without adequate resources. A mortality survey in the districts of Gulu, Kitgum and Pader showed that the crude and under- five reported mortality rates are well above their respective emergency threshold (1/10,000 and 2/10,000/day) at 1.54 per 10,000 and 3.18 per 10,000 per day respectively. Access to basic health care is inadequate as a result of severe staffing limitations and, in some areas, lack of accessibility due to on-going security threats. Congested and over-crowded camps provide squalid living conditions. Disease outbreaks caused by limited water supply and poor sanitation contribute to the increased morbidity and mortality rates. Children and women, who represent 80% of IDPs, are the most vulnerable group. The leading reported causes of morbidity are malaria, violence, respiratory tract infections and HIV/AIDS.

Response:Women hanging nets in maternity wards

As part of a UNICEF-funded project, the Malaria Consortium supported the Uganda Ministry of Health to bridge the gaps in malaria control in 5 districts in the north where the IDP camps are. The aims were:

  • To protect pregnant women with LLINs available through ANC services
  • To carry out sensitization of district and community leaders on malaria
  • To evaluate adherence to the home based management of fever blister pack (HomaPakTM)

Although LLINs were sometimes slow to be delivered, all districts are now distributing LLINs through ANC services, the distribution mechanism benefited from strong training and a focus on interpersonal communications to ensure pregnant women received key messages about use of the LLINs. Adherence to HomapakTM was assessed and found to be high.

Points to note:

The distribution model has been extremely successful with a recent survey demonstrating that over 90% of nets distributed 6 months previously were still owned by the women and use of LLINs by this group was over 85%. The model of distribution used has been taken up and expanded and the MC is now funded both by UNICEF and USAID (under the AFFORD project) to support the Ministry of Health to use this system for LLIN distributions in the whole of north, north eastern and north west Uganda.

 

 

For more info about AFFORD click here

 

 

Photo: Malaria Consortium