Ethiopia

Though malaria prevalence in Ethiopia is relatively low compared to other African nations, nearly 70 percent of the population lives in areas at risk of malaria. Prompt access to quality malaria case management, including laboratory-based diagnosis in remote rural areas, has improved dramatically over the last decade as have surveillance systems that capture malaria cases and deaths.

The U.S. President’s Malaria Initiative (PMI) has supported Ethiopia’s Federal Ministry of Health (FMOH) in conducting Indoor Residual Spraying (IRS) in the country since 2008. From 2011 through 2017, this support came through the PMI Africa Indoor Residual Spraying (AIRS) project. In September 2017, Abt Associates was awarded a five-year contract, PMI VectorLink (VL) project, to support malaria vector control activities, including the implementation of IRS in 25 countries, including Ethiopia. More specifically, the PMI VL project supports the PMI in planning and implementing IRS programs and other proven life-saving malaria vector control interventions, with the overall goal of reducing the burden of malaria in Africa.

Under AIRS, Ethiopia successfully implemented six IRS campaigns. In each of these spray campaigns, 36 districts in Oromia Region were targeted for spraying between 2012 and 2017. In 2017, the Project conducted IRS in an additional eight districts in Benishangul-Gumuz Region in the northwest of the country and targeted a total of 44 districts in both regions.

In 2018, under the PMI VectorLink Ethiopia project, IRS was conducted in 44 districts in three regions: Benishangul-Gumuz (20, 8 old and 12 new), Gambela (14, all new), and Oromia (10, all old), targeting 595,618 structures using Actellic 300 CS (pirimiphos-methyl, an organophosphate) from May 21 to July 31, 2018. A total of 472,569 structures were sprayed out of 485,358 structures found by spray operators in the targeted districts, accounting for a coverage rate of 97.4%. Over the course of the 2018 campaign, the target was adjusted to 574,042 due to security issues prohibiting teams from reaching certain areas, resulting in a progress of 83.2%. In total, 1,264,189 residents were protected, including 213,459 (16.9%) children under five years old and 28,944 (2.3%) pregnant women.

Table 1 provides an overview of the number of structures sprayed and population protected over the last four spray rounds.

Table 1: Structures and Population Protected by IRS, 2015–2018

  2015 2016 2017 2018
Number of districts covered by PMI-supported IRS 36 (Oromia) 36 (Oromia) 44

(36 in Oromia, 8 in Benishangul-
Gumuz)

44

(10 in Oromia,
20 in Benishangul-Gumuz, and 14 in Gambela)

Number of structures targeted 670,303 708,258 787,658 595,618
Number of structures found by SOPs 708,258 717,396 748,917 485,358*
Number of structures sprayed 704,945 715,541 738,810 472,569
Spray coverage (%) 99.5 99.7 98.7 97.4
Population protected 1,655,997 1,688,745 1,877,154 1,264,189
Children under 5 230,366 230,690 269,299 213,459
Pregnant women 23,084 23,011 29,271 28,944
Spray dates and insecticide used July–Aug:
Actellic 300 CS
Aug–Sep: Bendiocarb 80 WP
Jun–Aug:
Actellic 300 CS
Jun–Jul:
Actellic 300 CS
May–Jul:
Actellic 300 CS
Number of people trained with U.S. Government funds to deliver IRS 2,845 2,749 3,199 2,413

* The number of structures found by SOPs was low due to overestimation of the target number of eligible structures (estimated based on government data) and security concerns in some districts.

The PMI VectorLink Project is working with the FMOH, the Benishangul-Gumuz, Gambela, and Oromia regional health bureaus (RHBs), and the district health offices (DHOs) to spray 545,496 targeted structures in 20 districts in Benishangul-Gumuz, 14 districts in Gambela, and 10 districts in Oromia. The districts were selected by the FMOH and PMI based on current malaria morbidity data. The project’s primary objective is to reach a minimum coverage of 85 percent of the structures found in each district by implementing high-quality IRS operations.

Success stories from PMI VecotrLink Ethiopia:

Ethiopia Sees Dramatic Reduction in Malaria in IRS Region