Malaria is a leading public health challenge in Côte d’Ivoire. It accounts for about 43% of outpatient visits in health facilities. Malaria incidence in 2017 was 134 cases per 1,000 in the general population, and 247 per 1,000 among children under 5 (per the NMCP 2018 annual report).
The main malaria vector control method currently used in Côte d’Ivoire is the distribution and use of ITNs. ITN distribution is typically carried out through mass campaigns for universal coverage, and through routine distribution during antenatal visits and immunization of children under 1 year. The country’s 2016–2020 National Malaria Strategic Plan has selected IRS as an additional vector control method to reduce morbidity and mortality from malaria.
Since 2015, the NMCP has worked with four research institutes to conduct entomological monitoring including insecticide resistance monitoring and biannual vector surveillance (one collection in the dry and one in the rainy) in twelve sentinel sites selected across the country. These activities were implemented every two years in each of twelve sentinel sites (six sites one year and the other six the next year) from 2015-2017 with financial support from the Global Fund. PMI began supporting entomological monitoring in Cote d’Ivoire in 2018, enabling insecticide resistance monitoring in ten sites selected by the NMCP, four of which were also selected for monthly vector surveillance. In 2019, NMCP resumed biannual vector surveillance in all 12 sentinel sites with Global Fund support, PMI continued supporting monthly vector surveillance in another four sites (two selected for IRS and two control sites) through the VectorLink project, and insecticide resistance testing was conducted in 19 sites combined. Over the same period of time, several parallel entomological monitoring activities were conducted through the different research institute projects, including a three-year community evaluation of eave tubes funded by the Bill and Melinda Gates Foundation.
In its third year, The PMI VectorLink Côte d’Ivoire Project will conduct IRS in Sakassou and Nassian in April and June, respectively, and will provide capacity-building support to the national and district governments to plan and implement quality IRS in the future alongside with the continuous entomological monitoring.
In 2020, the PMI VectorLink Côte d’Ivoire project will work with the Ministry of Health, NMCP, Regional Health Direction, Department Health Direction, Ministry of Environment, Ministry of Agriculture, Ministry of Women, Families and Children, and with research institutes such as the Institut National d’Hygiène Publique (INHP), Centre Suisse de Recherches Scientifiques (CSRS), Centre d’Entomologie Medical et Veterinaire, and Institut Pierre Richet to spray 56,601 targeted structures in two health districts using SumiShield 50 WG and Fludora Fusion. The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each health district by implementing high-quality IRS operations.
In addition, the project will carry out the following activities:
- Support training and capacity-building at national, regional, and health district levels as a means of achieving IRS sustainability.
- Conduct training with a focus on IRS supervision and spray techniques to improve the overall quality of spraying.
- Conduct regular monitoring and evaluation (M&E) of project activities to ensure alignment with set targets and objectives.
- Carry out a logistics assessment in all health districts, and arrange all procurement, shipping, delivery, and storage of IRS commodities.
- Develop a robust IRS logistics and warehousing system through training and supervision.
- Build the NMCP and district health teams’ capacity in the area of inventory management, quantification, procurement, and distribution, through training.
- Work with the NMCP and other local partners such as Breakthrough Action, helping with coordination of information, education and communication (IEC), sensitization, and mobilization activities to raise awareness and encourage acceptance of IRS.
- Coordinate community mobilization activities in collaboration with stakeholders to raise awareness of IRS and to encourage beneficiary and stakeholder ownership.
- Collaborate with other implementing partners in the two health districts to complement each other’s work and ensure no duplication of efforts.
- Ensure safe and correct insecticide application, thus minimizing human and environmental exposure to IRS insecticides, in compliance with the Pesticide Evaluation Report and Safer Use Action Plan and Supplemental Environmental Assessment (SEA).
- Work with NMCP and the target directorates of Agriculture and Environment to ensure environmental compliance through environmental compliance inspections before, during, and after spraying.
- Mainstream gender equality and female empowerment by ensuring women’s participation in different project activities.
- Create the foundation for the impact evaluation of the 2020 IRS campaign through compiling and visualizing pre-campaign baseline data and 2020 IRS campaign data.
- Conduct insecticide susceptibility tests nationwide and measure the resistance intensity, as required, for the main malaria vector, gambiae s.l.
- Monitor the density, species composition, behavior, and Plasmodium sporozoite infection rates of malaria vectors in the four sites (two IRS health districts and two controls).
- Monitor the residual life of the sprayed insecticides using cone bioassays in IRS health districts.