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.
In its second year of implementation, the PMI VectorLink Project will work with the NMCP, the Malaria Alert Centre (MAC) of the College of Medicine, the Nkhotakota district health management team (DHMT), and other stakeholders to implement IRS in Nkhotakota district; and to conduct comprehensive entomological monitoring in 15 sentinel sites in seven districts. VectorLink Malawi will implement the 2019 spray campaign in 10 operations sites in Nkhotakota district. The spray campaign will be carried out over the course of 30 days beginning on October 17, 2019.
In its third year, VectorLink Malawi will work with the NMCP, PMI, Nkhotakota DHO, and other stakeholders to implement the spray campaign in Nkhotakota District. The campaign will spray the organophosphate pirimiphos-methyl CS and establish 10 operations sites to support all IRS activities. The project aims to achieve at least 85 percent spray coverage of 118,355 targeted structures and protect over a half a million residents. The project will also provide technical assistance, training support, and supervision to the NMCP-led IRS campaign in Mangochi.
The project will conduct IRS in Nkhotakota District from October 26 through December 4, 2020, and will provide capacity-building support to the national and district governments to plan and implement quality IRS in districts supported by the Global Fund. The map in Annex A illustrates the 2020 IRS operations sites and entomological monitoring sites in Nkhotakota district.
In 2020, the PMI VectorLink Malawi project will work with the NMCP, the Nkhotakota District health management team, and other stakeholders to spray 121,167 targeted structures in Nkhotakota District using the clothianidin-based SumiShield® 50WG, with a small area sprayed with the balance of the organophosphate Actellic® 300CS left over from the 2019 IRS campaign. 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.
Additionally, the project will carry out the following activities:
- Continue building 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 supported by the Global Fund implemented by the NMCP and WVI.
- 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 effectiveness of the spray program.
- 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 Malaria Consortium, MAC, and the NMCP to update the Malawi Integrated Vector Control Strategy (IVCS) (2020–2024).
- 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 sprayers, spare parts, insecticides, and personal protective equipment (PPE).
- Work with the NMCP and other local partners to coordinate information, education, and communication (IEC), sensitization, and mobilization activities to raise awareness and encourage acceptance of IRS.
- Provide regular monitoring and evaluation (M&E) for the IRS program.
- Integrate gender equality and female empowerment into IRS planning and implementation in line with USAID’s Gender Equality and Female Empowerment Policy and VectorLink’s Gender Strategy.
Success stories from PMI VectorLink Malawi: