Despite progress, malaria continues to be a major public health problem in Malawi. The disease accounts for 40 percent of hospitalizations in children under five, 30 percent of all outpatient visits, and is one of the major causes of morbidity and mortality across all age groups. Transmission is perennial in most areas and peaks during the rainy season from November to April. With support from PMI and other partners, the Ministry of Health’s National Malaria Control Program has been able to scale up the distribution of ACTs, IPTp using SP, and ITNs. Progress to date is promising; the mortality rate for children under five years of age fell by 36 percent between 2004 and 2014, to an estimated 85 deaths per 1,000 live births.
Through PMI support, VectorLink Malawi has conducted three rounds of IRS (in 2018, 2019, and 2020) in Nkhotakota District. Prior to 2018, IRS had not been carried out in Nkhotakota since 2012 due to lack of funding. In 2019, the NMCP, in collaboration with World Vision International (WVI) and with the financial support of the Global Fund, conducted IRS in Mangochi District using the organophosphate Actellic 300 Capsule Suspension (CS). In 2020, the NMCP and WVI extended IRS to Balaka and Nkhata Bay districts, bringing the number of IRS districts supported by the Global Fund to three. Nkhata Bay District and part of Mangochi District used the organophosphate Actellic 300CS, while Balaka and part of Mangochi District used the neonicotinoid SumiShield 50WG.
In 2021, the PMI VectorLink Malawi Project will work with the NMCP, the Nkhotakota District health management team, and other stakeholders to spray 125,521 targeted structures in Nkhotakota District using Fludora Fusion and SumiShield 50WG. The project’s primary objective is to reach a minimum coverage of 85% of the structures found in Nkhotakota District by implementing high-quality IRS operations. The project will also provide technical assistance, training support, and supervision to the Global Fund-supported IRS campaign in Mangochi, Balaka, and Nkhata Bay districts, which will be sprayed with Fludora Fusion.
Additionally, the project will carry out the following activities:
- Continue scaling up the capacity of the NMCP and district health teams in coordination, implementation, and supervision of IRS activities.
- Provide technical assistance during the planning and implementation of spray operations implemented by the NMCP and WVI with Global Fund support.
- Provide financial and technical support to the Malaria Alert Centre (MAC) of the University of Malawi College of Medicine for entomological monitoring. MAC will continue conducting comprehensive entomological monitoring activities, insecticide resistance monitoring, and advanced entomological analysis that will generate critical data on the quality and effectiveness of the spray program. MAC will also support the initial stages of the streamlined durability monitoring for the 2021 mass ITN distribution.
- Strengthen the national Vector Control Technical Working Group (VCTWG) to ensure it meets regularly and adequately advises the NMCP on issues related to malaria vector control.
- Work with the NMCP, Environmental Affairs Department (EAD), and District Environmental Sub-Committee (DESC) to ensure environmental compliance through inspections before, during, and after spraying.
- Carry out logistics assessments and arrange all procurement, shipping, delivery, and storage of all equipment.
- Work with the NMCP and other local partners to coordinate information, education and communication (IEC), sensitization, and mobilization activities to raise awareness, encourage acceptance of IRS, and mitigate risk of refusals due to fear/misconceptions and expressed preference for ITNs.
- Provide regular monitoring and evaluation (M&E) for the IRS program.
- Integrate gender equality and women’s empowerment into IRS planning and implementation in line with USAID’s Gender Equality and Women’s Empowerment Policy and VectorLink’s Gender Strategy.
Success stories from PMI VectorLink Malawi: