The President’s Malaria Initiative (PMI), in partnership with the United Sates Agency for International Development (USAID and the Centre for Disease Control (CDC), is working to reduce malaria related morbidity and mortality by 50% in Liberia by 2012, focusing on reaching pregnant women and children under 5 years of age with lifesaving services, supplies, and medicines.
The PMI’s project focuses on preventing malaria through four interventions, namely the distribution of insecticide-treated nets (ITN), supporting indoor-residual spraying (IRS), and making rapid diagnostic tests (RDT) and malaria medication available. By increasing the use and accessibility of insecticide-treated nets and malaria-preventative medication in pregnant women, PMI hopes to decrease mortality rates. In addition, activities that aim to increase skills, knowledge, and awareness of the disease are designed to help curb the growing number of malaria-related problems.
To support these approaches, capacity building activities included training 2067 mid-level health care workers, community health volunteers (CHV), and traditional midwives in malaria case management and malaria in pregnancy. They were also given the skills to do malaria education which included behavioural change communication messages. One of the topics covered in the training was the importance of educating patients on early treatment seeking behaviour and intermittent preventative treatment in pregnancy (IPTP).
PMI also supports the promotion of malaria prevention and control interventions through mobilising schools, communities, local and international NGOs, leaders of all kinds, and faith-based organisations, such as churches. Through the malaria community programme (MCP), PMI has also partnered up with the MENTOR Initiative to promote community awareness of malaria. This has included developing community-based malaria groups who work together to develop dramas, songs, and posters. Cultural troops in the community performed dramas, and recorded them as radio and television/video programmes. Songs have played on local and national radio stations and the posters created were displayed in key areas such as health facilities, schools, and public meeting areas.
According to PMI, the malaria crisis in Liberia is quite severe; it is the primary cause of morbidity and mortality in the country, contributing to 38% of outpatient consultations. A malaria indicator survey (MIS) in 2008-2009 showed that the malaria parasite was found in 32% of blood slides taken from children 6 months to 5-years old. The objective of this initiative is to reduce the malaria-related morbidity and mortality rates by reaching 85% of the affected areas, particularly pregnant women and children under the age of five.
In 2009, 480,000 ITNs were procured and distributed for free through door to door and antenatal care campaigns in three counties – Nimba, Grand Bassa and Lofa – reaching an estimated 700,000 people. ITN ownership increased from 18% to 60% between 2005 and 2009. However, PMI found that only about half the people who own nets use them on a regular basis, suggesting that a lot of work needs to be done to promote regular mosquito net usage.
USAID, Centre for Disease Control (CDC), John Snow International, RTI International, Medical Care Development International, EQUIP, MENTOR Initiative, Macro, Medical Centre Development, Management Science for Health Inc., US Pharmacopeia Convention