Rwanda has made remarkable progress in the fight against malaria. All major malaria indicators have decreased significantly from 2005 to 2012. Rwanda’s health management information system reported an 86 percent reduction in malaria incidence, an 87 percent reduction in malaria morbidity, a 74 percent reduction in malaria mortality, and a 71 percent reduction in malaria test positivity rate. The national malaria control program has an ambitious vision of a Rwanda free from malaria and is aiming to achieve malaria pre-elimination status nationwide by 2018.
Through PMI support, Rwanda has conducted 18 spray rounds, nine of which have been implemented by the PMI AIRS Project and one by VectorLink Rwanda. The most recent spray round (September 2018) was carried out in Kirehe and Nyagatare districts, over 20 days between September 10 and October 2, 2018, using the organophosphate insecticide Actellic 300CS. Of the 208,687 structures that spray operators found in the targeted districts, 208,026 were sprayed, a coverage rate of 99.7 percent. In total, 831,735 residents were protected, including 117,878 children under the age of five years (14.2 percent) and 12,131 pregnant women (1.5 percent). Annex A lists coverage and population protected statistics for 2007-2020.
In the 2019 spray round (which includes the early-2020 spraying in Ngoma), VectorLink Rwanda will work with the MOPDD and other stakeholders to achieve at least 85 percent spray coverage of the 298,018 targeted structures identified in 40 sectors in the three aforementioned districts, thus protecting 1,215,859 residents. The insecticide used will be Fludora Fusion. Additionally, VectorLink Rwanda will provide technical support to MOPDD spraying of the Mahama refugee camp in Kirehe. The camp, which currently hosts about 53,325 Burundian refugees, has 6,780 structures.
In addition to spraying, the project will:
- In addition to spraying, the project will carry out the following activities:
- Support training, capacity building, and advocacy at the national, regional, and district levels as a means of facilitating IRS sustainability. The project will work to increase the role of the district and the MOPDD in supervising IRS in 2019. This will include training on the use of a smartphone application for spray supervision.
- Provide regular monitoring and evaluation (M&E) updates and supervision, including a daily Performance Monitoring Tracker.
- Use supervisory data collection tools through an m-Health system for real-time feedback and decision making.
- Roll out VectorLink Collect, the new database system for IRS and entomological data, which has been built on the District Health Information System 2 (DHIS2) platform.
- Carry out a logistics assessment in all districts and arrange all procurement, shipping, delivery, and storage of spray tanks, spare parts, insecticides, and personal protective equipment (PPE).
- Ensure safe and correct insecticide application, thus minimizing human and environmental exposure to IRS insecticides.
- Coordinate information, education, and communication (IEC) and behavior change communication (BCC) sensitization and mobilization activities with other stakeholders.
- Promote cost efficiency through due diligence and efficiency of operations.
- Provide technical assistance during spray rounds conducted by the MOPDD in the eight districts of Bugesera, Gisagara, Huye, Kayonza, Gatsibo, Ngoma, Nyanza, and Rwamagana, plus the Mahama refugee camp in Kirehe District. The MOPDD is planning to spray high burden malaria districts mentioned above during the period of January through April 2019. The VectorLink technical assistance will include training of spray teams, data management, inventory management, environmental compliance and supervision of spray operations in the aforementioned districts.
Insecticide-Treated Net (ITN) Activities
- VectorLink Rwanda, will support the MOPDD to conduct ITN durability monitoring following the 2019 mass campaign distribution. The study will provide MOPDD, PMI, and stakeholders with updated evidence on ITN survivorship, physical durability, and insecticide effectiveness to inform procurement and programmatic decisions for future ITN campaigns and continuous distribution.