Overview on the Malaria Grant

Background

The Program has made significant progress in recent years. Although not all targets in malaria burden reduction were met, malaria mortality has been reduced from 15.2 per 100,000 population in 2015 to 7 per 100,000 population in 2019 exceeding the target of 9 per 100,000. The malaria incidence declined from 335 (per 1,000 population) in 2015 to 296 in 2019, short of the target of 191. The malaria prevalence in children under five reduced from 17% in 2015 to 9% in 2018. The proportion of suspected malaria cases receiving parasitological diagnosis increased from 88% in 2015 to 98% in 2019.

The malaria grants for the period 2021-2023 in Zambia will continue to be implemented by two Principal Recipients: the Ministry of Health will work at national level with the Medical Stores Limited while the Churches Health Association of Zambia (CHAZ) will focus on interventions at community level.

The Program aims to maintain high levels of coverage across all interventions and expects to achieve universal coverage of vector control by the end of 2020. In 2021 and 2022 IRS will need to be repeated at similar level, whereas from 2023, the Program aims to deploy LLINs as the primary vector control intervention and scale back IRS to be deployed in hot spots.

Goals

To eliminate local malaria infection and disease in Zambia by 2021
To maintain malaria-free status and prevent reintroduction and importation of malaria into areas
where the disease has been eliminated

Strategies

Increase the implementation rate of interventions from 36% in 2015 to 95% by 2021;
Reduce malaria incidence from 336 cases per 1,000 population in 2015 to less than 5 cases per
1,000 population by 2021;
Increase the malaria-free health facility catchment areas (HFCAs) from 0.5% in 2015 to 100% in
2021; and
Reduce malaria deaths from 15.2 deaths per 100,000 in 2015 to less than 5 deaths per 100,000
population by 2021.

Planned Activities

The Program activities include supporting

Vector control (LLINs for continuous and mass distribution channels, IRS and entomologic monitoring);
Case management (diagnostics such as microscopy and RDTs; first-line antimalarial drugs such as ACTs, and iCCM); and
Health systems strengthening related to M&E, community systems strengthening, Human Resources for Health, and Financial management.

1. Vector Control
Procurement of LLINs and support to 2023 mass campaign (MoH)
Procurement of LLINs and support to distribution to infants and pregnant women through ANC and EPI, targeted areas (CHAZ)
Procurement of insecticide and support for IRS campaigns (MoH)
Entomological monitoring for insecticide resistance (MoH).

2. Case management
Procurement of ACTs and RDTs (MoH&CHAZ) and Artesunate and Sulfadoxine Pyrimethamin (SP) (MoH)
Procurement of microscopy reagents, materials and consumables (MoH) and of microscopes (CHAZ)
Generation of proficiency diagnostic testing materials and training (MoH&CHAZ))
Supervision and quality assurance activities (MoH&CHAZ)
ICCM trainings and support visits (MoH&CHAZ)
Support around quantification and consumption of malaria commodities (MoH&CHAZ)

3.1 RSSH: Health management information systems and M&E
Program and data quality interventions such as trainings, data quality audits (MoH&CHAZ)
Malaria Indicator Survey (MIS) (MoH)
Therapeutic efficacy study (MoH)
Building linkages with various stakeholders such as parliamentarians, speaker of National Assembly, religious bodies, members of House of Chiefs (MoH)

3.2 RSSH: Community systems strengthening
Meeting to validate and finalize malaria elimination communication campaign materials (MoH&CHAZ)
Workshops to develop SBCC messages and materials; and field testing (MoH)
Electronic Products and promotional materials for commemoration of Annual Malaria Events (MoH&CHAZ)

3.3 RSSH: Human resources for health, including community health workers
Salary and gratuity for Community Health Assistants (MoH)

3.4 RSSH: Financial management system (MoH&CHAZ)
Capacity building and trainings
Support to governance systems
Technical Assistance
Financial Sub Recipients supervision, mentorship and review