Week 1 – Counting Malaria Out for Pregnant Women in Nigeria

Week 2 – From One to Many: Scaling up Malaria in Pregnancy Interventions in Tanzania

Week 3 – Counting on the next generation of midwives to count malaria in pregnancy out

Week 4 – Counting on the team to count malaria out

Week 5 – Fighting Malaria in Pregnancy through Community Health Workers in Rwanda

Week 6 – Data Management for Improved Decision-Making: Counting Malaria in Pregnancy Control Success in Angola

Interview with William Brieger,
Senior Malaria Specialist at Jhpiego

Jhpiego: Counting Down to the Day We Can Count Malaria Out

On World Malaria Day, the Roll Back Malaria Partnership will begin its two-year “Counting Malaria Out” campaign, which will call on malaria-endemic countries, Roll Back Malaria partners and donors to contribute increased efforts to comprehensively “counting,” or tracking, progress toward 2010 Millennium Development Goals. Tracking the effectiveness of malaria prevention and treatment activities is essential as researchers continue the long struggle towards eradication.

When “counting” the effectiveness of Jhpiego’s malaria programs, we apply a four-step process.

Step one: Ensure that existing health information systems accurately capture information on the provision of malaria services. In this regard, Jhpiego is working in countries like Nigeria, Angola, Kenya, Tanzania and Ghana to improve and update antenatal care (ANC) registers, cards and record forms to capture malaria-related information. Specifically, ANC registers are modified to include easily identifiable sections where nurses and midwives can record when a pregnant woman receives intermittent preventive treatment in pregnancy (IPTp) or an insecticide-treated bed net (ITN).

Step two: Make sure health workers to count their malaria commodity stocks and review the number of people they have served to determine future needs. Jhpiego has found in Tanzania, for example, that it is important to compare records of malaria supplies that are in stock with clinic service records. Not surprisingly, in the places with regular supplies of sulphadoxine-pyrimethamine, the drug used for IPTp, higher proportions of pregnant women are protected from malaria than in clinics where stocks of malaria medicines run out. Jhpiego counts the stock of malaria service supplies and, subsequently, works to ensure that stock registers are maintained—demonstrating to clinic staff the appropriate times to order malaria commodities.

Step three: Count people in the community, not just those who visit clinics. Jhpiego has learned that counting only women who attend ANC is not enough because this approach misses opportunities to count individuals who do not attend or register for ANC services. In some situations, a large number of pregnant women do not register for ANC. Instead, they choose to seek care from private clinics, religious houses and local birth attendants who cannot provide malaria control services—as was the case in Akwa Ibom State, Nigeria. However, Jhpiego conducted a community survey to obtain an accurate count of the number of pregnant women benefiting from malaria control services in Akwa Ibom State.

Step four: Count the number of health service units that actually provide malaria control services and the number of communities they reach. Initially, Jhpiego may work with a few health facilities or districts to test a new program approach. For example, we are currently pilot-testing new malaria interventions: community-directed distribution of IPTp in Nigeria and improving health worker performance in Angola. And once we identify how best to package these interventions, we will scale up to additional health facilities and districts. It is only when Jhpiego can count all malaria-endemic communities covered by our interventions that we will be able to precisely discuss the elimination of malaria in a country.

Ultimately, the international health community—from community leaders and volunteers to health supervisors and program managers—needs to get every interested party involved in counting, analyzing and using information about coverage of malaria services. Every one counts when it comes to counting malaria out.

To find our more about Jhpiego’s work in malaria please visit: http://www.jhpiego.org/whatwedo/malaria.htm

About Jhpiego

Jhpiego, (pronounced "ja-pie-"), is an international non-profit health organization affiliated with The Johns Hopkins University. For nearly 40 years, Jhpiego has empowered front-line health workers by designing and implementing effective, low-cost, hands-on solutions to strengthen the delivery of health care services. By putting evidence-based health innovations into everyday practice, Jhpiego works to break down barriers to quality health care services for the world’s most vulnerable populations.