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URC Health & Population Focus Areas

Malaria

More than 300 million cases of malaria each year result in over one million deaths, with over 90% of these deaths occurring in Africa, mostly among young children. Malaria remains the leading cause of mortality in many African countries, disproportionately affecting young children and pregnant women.

In line with the priorities of the President’s Malaria Initiative, URC supports quality improvement activities and research in Africa aimed at expanding preventive therapy in pregnant women and use of insecticide-treated bednets, increasing appropriate care-seeking behavior, strengthening malaria diagnosis and case management, improving the prompt use of artemisinin-based combination therapies (ACTs), and increasing adherence to treatment.

URC, through its non-profit partner Center for Human Services, is also collaborating with the World Health Organization (WHO) and the Bill and Melinda Gates Foundation to conduct field research to improve diagnosis and treatment of malaria in remote and underserved areas.

Current URC/CHS malaria activities:

• QAP is developing a RDT Job Aid in Zambia for health workers. Click on graphic for larger image.

  In Benin, the USAID-Funded Integrated Family Health Project ( Projet Intégré de Santé Familiale or PISAF) is providing technical assistance and support for implementation of the national malaria policies. PISAF is working with the Departmental Health Directorate’s malaria offices in the Zou and Collines regions to review ongoing malaria activities and assist with training health workers on the new malaria protocol. In addition, based on monitoring tools of the Programme National de Lutte Contre le Paludisme (National Malaria Control Program), PISAF is developing a follow-up plan for distribution of long-lasting insecticide treated bednets through prenatal care visits as well as a follow-up plan for Artemisinin-based combination therapy (ACT) distribution. PISAF will participate in the 2008 workplan consensus meeting of the President’s Malaria Initiative (PMI) to review the situation analysis and define priority interventions for 2008-2011.
• Through the USAID-funded Quality Assurance Project, URC supports Pediatric Hospital Improvement (PHI) Collaboratives in Niger and Tanzania that are strengthening the quality of malaria diagnosis and case management for children under five treated at the district hospital level, particularly for severe life-threatening pediatric malaria and its complications Ongoing operations research is assessing the impact of the Niger PHI Collaborative for improving child malaria diagnosis and care in district hospitals.
• As part of their antenatal programs, Essential Obstetric and Neonatal Care (EONC) Collaboratives supported by QAP in Benin and Niger target improved prevention of malaria in expectant mothers, applying intermittent preventive therapy (IPT) and improved treatment of malaria for expectant mothers and their unborn babies who are at risk. In addition to promoting prevention and prompt ACT therapy, the collaboratives also promote access to and distribution of insecticide-treated nets (ITNs).
• Also in Benin, URC is providing technical assistance to Plan International to apply the improvement collaborative approach to strengthen community-based malaria services.
• In Zambia, URC is working with and the National Malaria Control Center and WHO to develop and field test simplified instructions aimed at low-literacy community health workers for malaria rapid diagnostic tests (RDTs). Follow-on research is in development to address critical operational issues raised by widespread RDT use in Africa, including safe blood handling practices, appropriate disposal of medical waste (including sharps), proper storage and handling of the test kits prior to use, clinical judgment on the part of the community health workers about when to treat based on test results and when to treat presumptively, and what workers should tell patients who are febrile but RDT‑negative.
• With Gates funding, CHS is conducting field research on rapid, home-based tests for malaria for use with adults and children with fever. The research, currently underway in Tanzania, is examining potential demand among public and private service providers and health care consumers as well as examining the likely effects of factors such as price, sensitivity, specificity, and practicality on potential demand.

For more information on URC/CHS efforts to reduce maternal and child morbidity and mortality from malaria, contact Dr. Kathleen Hill at khill@urc-chs.com. For more information on our malaria field research, contact Dr. Steve Harvey at sharvey@urc-chs.com.