Malaria is the primary cause of morbidity and mortality in Mali, particularly among children under the age of five. While the entire population is at risk for malaria, internally displaced persons migrating from the north are especially vulnerable given their low immunity to infection. Due to the diversity of malaria transmission in Mali, the malaria control strategy emphasizes both universal coverage of key malaria interventions, as well as a specific epidemic and entomological surveillance, and targeted operational research.
In 2019, PMI VectorLink Mali again conducted IRS in Mopti Region, in 35 geographically contiguous health areas (Aires de Santé), this time in three districts: Bandiagara, Djenné, and Mopti. It targeted a total of 149,919 structures in the three districts and sprayed Actellic® 300CS in Bandiagara and Mopti, and SumiShield® 50WG in Djenné. Over the period July 1 to August 4, 2019, it sprayed a total of 148,198 structures (332,991 rooms) out of 153,191 structures (362,694 rooms) found by the project spray operators (SOPs) in the targeted areas, accounting for a coverage rate of 96.7%. The 2019 IRS campaign was carried out under highly unstable security conditions, which at times prevented spray teams from adhering to the spray calendar, and prevented senior supervisors from conducting supervision in these villages.
In 2020, PMI VectorLink Mali conducted IRS in 28 geographically contiguous health areas (Aires de Santé) across these same three districts in Mopti Region, Bandiagara, Djenné, and Mopti. The project targeted a total of 119,906 structures in the three districts, and sprayed SumiShield® 50WG in Bandiagara, Actellic® 300CS in Djenné, and Fludora® Fusion WP-SB (used for the first time in Mali) in Mopti. Over the period June 15 to August 12, 2020, the project sprayed a total of 129,302 structures out of 133,426 structures found by spray operators (SOPs) in the targeted areas, for a coverage rate of 96.9%. The VectorLink Mali leadership team adapted IRS activities to mitigate personnel’s relative risk of exposure to both security and COVID-19 challenges before, during, and after spray activities to ensure staff and beneficiary safety.
In 2021, the PMI VectorLink Mali project will work with the NMCP/MOH to spray 65,105 targeted structures in 19 geographically contiguous health areas out of the 76 total health areas in Bandiagara, Djenné, and Mopti districts, using Fludora® Fusion WP-SB, SumiShield® 50WG, and Actellic® 300CS, respectively. The project’s primary objective is to reach a minimum spray coverage of 85% of the eligible structures in each district by implementing high-quality IRS operations, and to an estimated population of 269,823. More specifically, the IRS campaign aims to cover:
- 23,389 structures in Bandiagara, in the 7 target health areas (of 27 total),
- 27,822 structures in Djenné, in the 7 target health areas (of 22 total), and
- 13,894 structures in Mopti, in the 5 target health areas (of 27 total).
In addition to spraying, in Year 4 (2021), the project will carry out the following activities:
- Continue to engage NMCP/MOH personnel in the planning, implementation, and supervision of IRS in the three districts and at the regional and central levels.
- Continue scaling up capacity at the national, regional, district, and local levels to manage IRS operations. Particular emphasis will be put on strengthening NMCP’s monitoring and evaluation (M&E) and entomological monitoring skills in subsequent years. The project will engage the designated national representatives in these activities, from the development through use and analysis.
- Collaborate with the NMCP/MOH and regional/district health officials on developing and implementing an IRS transition/sustainability strategy and concrete plans to transfer IRS responsibilities over the remaining years of the project.
- Continue efforts to mainstream gender equality and female empowerment by increasing women’s participation in IRS activities. The project will continue to encourage health area selection committees to achieve the mandatory quota representation of female seasonal workers defined by district (at least 30%), as well as to offer promotions to high-performing female workers.
- Coordinate community mobilization activities in collaboration with local authorities (village chiefs and neighborhood leaders) to systematically raise awareness and increase community acceptance of IRS.
- Conduct, in partnership with the NMCP/MOH and other stakeholders, high-quality entomological monitoring (insecticide resistance, wall bioassay, vector density and behavioral studies) to select appropriate insecticides and ensure effective rotational strategies for subsequent spray campaigns.
- Pursue and sustain the community-led surveillance, which was piloted in 2020, as part of entomological monitoring approaches.
- Conduct robust M&E of project activities, including real-time performance monitoring during the IRS campaign, to ensure alignment with set targets and objectives.
- Conduct IRS environmental inspections in close collaboration with the National Directorate for Sanitation and Pollution Control (Direction National de l’Assainissement, Contrôle de Pollution et de Nuisances, DNACPN)/Ministry of Environment (MOE)).
- Enter all vector bionomics and insecticide resistance data into the District Health Information System 2 (DHIS2)-based VectorLink Collect instance on a timely and consistent basis.
- Evaluate the impact of Interceptor® G2 (IG2) ITNs in the Sikasso region.
- Strengthen the capacity of the NMCP and the PMI Data Specialist to develop and use integrated visualizations to support vector control decision-making.
- In 2021 and beyond, continue to participate in the validation and implementation of the Integrated Vector Control Strategy in collaboration with the NMCP, MOH, World Health Organization (WHO), and other relevant stakeholders, and provide evidence and expertise influencing decisions around rotational strategies in IRS implementation as well as ITN use throughout Mali.