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 its third year, the project will conduct IRS in three districts (Bandiagara, Djenné and Mopti) from June 22, 2020 to July 26, 2020, and will provide capacity-building support to the national, regional and district governments to plan and implement quality IRS in the future. Figure 1 below highlights the target districts for 2020.
In 2020, the PMI VectorLink Mali project will work with the NMCP/MOH to spray an estimated 256,992 rooms from 109,461 targeted structures in 28 geographically contiguous health areas out of the 76 total health areas in Bandiagara, Djenné, and Mopti districts, using Actellic® 300CS, SumiShield® 50SW, and Fludora® Fusion. The project’s primary objective is to reach a minimum spray coverage of 85% of the eligible structures found in each district by implementing high-quality IRS operations and protect an estimated population of 508,794. More specifically, the IRS campaign aims to cover:
- 37,043 structures2 (or 78,963 rooms) in Bandiagara, in the 10 target health areas (of 27 total),
- 23,880 structures2 (or 50,906 rooms) in Djenné, in the 7 target health areas (of 22 total), and
- 48,538 structures2 (or 127,123 rooms) in Mopti, in the 11 target health areas (of 27 total).
In addition to spraying, in Year 3, the project will carry out the following activities:
- Continue building capacity at the national, regional, district, and local levels to manage IRS operations, including planning, spraying, and monitoring and evaluation (M&E).
- Engage NMCP/MOH personnel in the planning, implementation, and supervision of IRS in the three districts and at the regional and central levels.
- Collaborate with the NMCP/MOH and regional/district health officials on developing 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 encourage health area selection committees to achieve the mandatory quota representation of female seasonal workers defined by district (at least 30%), as well as offering a promotion 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 monitoring, and behavioral studies) to select appropriate insecticides and ensure rotational strategies for future spray campaigns. As part of entomological monitoring approaches, pilot community-led surveillance will be conducted for sustainability.
- Conduct robust monitoring and evaluation 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)/MOE.
- Build the capacity of the NMCP and the PMI Data Specialist to develop and use integrated visualizations to support vector control decision-making.
- Conduct, in partnership with the Laboratory of Applied Molecular Biology (LBMA), the third year of ITN durability monitoring.
- Roll out the VectorLink Collect District Health Information System 2 (DHIS2)-based data management system for entomological data collection and analysis.
- Continue generating and supporting the use of data visualization for vector control decision making at the national, regional, and district levels.