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Malaria Control in Cambodia (MCC) Project


Funded by: US Agency for International Development

Project Duration: 2007-2011

Countries: Cambodia

Partners:

Partners for Development (subcontractor)


Overview

The Malaria Control in Cambodia (MCC) Project, implemented by University Research Co. LLC (URC), is a community-based malaria control and prevention project that aims to reduce malaria in the Western part of Cambodia, home to drug-resistant malaria.  Funded by the United States Agency for International Development Regional Development Mission for Asia (USAID/RDMA) since October 2007, the project provides technical assistance and support to the Cambodian National Malaria Control Program (NMCP), in collaboration with Partners for Development (PfD) and other non-governmental organizations (NGOs) involved in malaria control.

Key Activities

Prevention

  • Provide technical and financial support to malaria program at Operational District (OD) and Provincial Health Department (PHD) levels to distribute ITNs and re-treat conventional bednets for communities, including mobile and migrant populations.
  • Conduct communication outreach efforts to educate the public on safe behaviors to prevent malaria transmission using a variety of venues.

Care and treatment

  • Support training of public, private, and community providers on malaria case management, including early diagnosis and appropriate treatment, and patient referral (especially for private providers)
  • Develop and improve logistics procedures by procuring additional diagnostic tools and facilitating supply management to ensure adequate supplies at peripheral level.

Institutional development

  • Support the malaria program at OD and PHD levels by strengthening managerial capacity, including planning, coordination, and monitoring and evaluation procedures.
  • Support National Malaria Control Program to develop policy and strategies to contain any parasite resistance to artemisinin derivatives.
Achievements

Prevention

Working through community network including Village Health Volunteers (VHV) and Village Malaria Workers (VMW) and with Provincial and District malaria supervisors, URC-MCC has reached 340,000 people with malaria related health education and distributed 2,000 new insecticide treated nets (ITNs).  During Malaria Week 2011 alone, over 6,000 bednets were re-impregnated, 1,800 people were screened for malaria, and 46 were treated. 

Diagnosis

URC-MCC is supporting training of public, private, and community providers on malaria case management, including early diagnosis and appropriate treatment.  This includes increasing diagnosis of malaria using rapid diagnostic tests (RDTs) and microscopy, in comparison to clinical diagnosis alone. 

To strengthen the quality of microscopy confirmations, a URC laboratory specialist provides on-the-job training and coaching to laboratory technicians, and also cross-checks slides to monitor quality.  During the two years of the project, the proportion of labs with a functioning quality control system for malaria microscopy has increased from 44% to 100%.

Care and Treatment

URC-MCC has provided training, on-the job coaching, and supervision to increase correct treatment of malaria according to National Treatment Guidelines.  The results have been more significant for the treatment of complicated malaria which has a more complex treatment protocol. The project has maintained over 90 percent correct treatment for uncomplicated malaria cases and has gradually improved management of complicated malaria cases.

URC-MCC has expanded the role of VMWs to include diagnosis and treatment of uncomplicated malaria.  Over 500 VMWs in the target areas have received training on malaria diagnosis and treatment, and regularly received RDTs and drugs from their health centers.  As a result, the proportion of confirmed malaria cases treated by VMWs has doubled. 

Impact

Overall, the number of confirmed malaria cases has decreased.  The slide positivity rate (proportion of malaria slides that are confirmed positive) has decreased from 30% at baseline to 22% at the end of 2009.

The number of severe malaria cases and the malaria case fatality rate (CFR) reported by health centers has declined, indicating that malaria patients are being diagnosed and treated earlier.  This is a result of the involvement of VMWs who are more easily accessible to community members.  

Expertise
Malaria

Approaches
Quality Improvement; Health Systems Strengthening; Health Communication and Behavior Change


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