Home Management of Malaria

Ms Melanie Caruso, IFRC

Mr James Olle, YMI

In March 2012, International Projects Coordinator James Olle travelled to Kenya on behalf of Y’s Men International to visit the Home Management of Malaria (HMM) pilot project at the invitation of the International Federation of Red Cross and Red Crescent Societies (IFRC).

Y's Men and YMCA visits in Nairobi

Before joining the IFRC team, James met with Y’s Men and Y’s Youth in Nairobi for several meetings, and YMCA and Y's Men project visits.

IYR (10-12) Viny & Y's Youth George at Msamaria Mwema Children's Home in Kiambiu, Nairobi with the centre's manager, Agnes
James meets some of the kids at the Kibeira YMCA school, Nairobi
Cooking equipment at Kibeira YMCA supplied by Y's Men from Canada
James with PIP Benson and Mrs Mary Wabule

HMM Mission

The four-day mission took place between 22-25 March and covered the coastal area of Malindi and Lamu. James was accompanied by Ms Melanie Caruso, a staff member from the Geneva office of the IFRC and the Home Management of Malaria focal point in Geneva, and Mr Miko Thomas, malaria delegate with the IFRC covering the West and Central Africa region. With them also were two representatives from Burkina Faso: Dr Clarisse Bougouma from the National Malaria Control Programme (NMCP) and Dr Maxime Yameogo from the Burkina Faso Red Cross who are working together to establish an integrated community case management programme in their country to address childhood diseases including malaria.

(L-R) Melanie (IFRC), Adele (KRC volunteer), Dr Clarisse (NMCP), James (YMI), Dr Maxime (BFRC), Miko (IFRC), Ruth (KRC), Hadija (KRC)

Kenya Red Cross Society

During the trip the delegation collaborated closely with staff and volunteers from the Kenya Red Cross Society from headquarter and branch levels who coordinated the many logistical and technical aspects of the visit.

Home Management of Malaria

Home Management of Malaria is a strategy to improve access to appropriate and effective malaria treatment in the community or home through early recognition of malaria symptoms, together with prompt treatment. Community-based volunteers are trained to recognise fever and distribute pre-packaged malaria treatments in their community, providing families with access to first-line drugs in areas where trained health professionals are not available or where there is limited access to this medication. Community volunteers are also trained in the recognition of severe illness and in the importance of adherence to the full dose. Children with severe illness and those who do not improve after the first treatment are referred to the nearest health facility for immediate attention by a trained health care professional.

HMM Strategy

Early identification of malaria followed by prompt and effective treatment shortens the duration of the illness, prevents the progression to severe illness and prevents the majority of deaths from malaria, especially in young children. The volunteers are monitored and supervised by trained Ministry of Health coaches. They carry out a vital role in educating the community on prevention methods and on what options there are for treatment when malaria does strike. They are also trained to provide first aid.

HMM Coaches and Volunteers

During this trip, the delegation met and spoke closely with both the volunteers and coaches involved in the HMM project to gain a thorough insight into the project and to understand the challenges they face.

24 Million at Risk

Malaria has been a major problem in Kenya, with 24 million out of 35 million Kenyans at risk of malaria and it accounting for 30% of outpatient and 15% of the inpatient consultations in health facilities. In 2006, the Ministry of Health (MOH) estimated that malaria was the cause of 20% of all deaths in children under- five (U5) years of age. The Division of Malaria Control (DOMC) estimated that on an average 72 children die of malaria each day in Kenya. The National Malaria Strategy (2009-2017) introduced in November 2009, has been designed to reduce morbidity associated with malaria by 30% by 2009 and to maintain it until 2017.

Implementation

HMM is currently being implemented in 113 villages in Malindi and Lamu districts, remote areas with high malaria burdens, poor access to health care services, difficult terrain and high poverty rates. Participating villages are hard to reach and represent the most marginalised communities with least access to health services. In order to ensure timely access to life-saving treatment, Community Health Workers (CHWs) have been trained in each of these villages to administer Artemether Lumefantrine (AL) to clinical malaria cases in under-fives.

Results

Four years ago when the HMM project was initiated, the prevalence of malaria in Malindi was 35% and hence the area was categorised as a high malaria endemic area. Since the introduction of HMM the prevalence has decreased to less than 4% and it is no longer considered a high endemic area. As the Kenya Red Cross Society presented the results of their first quarter of 2012, they revealed that 93.7% (3,656) of fevers reported were treated within 24 hours and an additional 3.4% (133) were treated between 24 and 48 hours. This represents continued success of the project in treating more than 60% of fevers reported within 24 hours.

Next Phase

The success of the project in Malindi and Lamu districts has resulted in the inclusion of HMM in the Government of Kenya’s malaria management policy. Meanwhile, the project in the current sites in Coast Region is moving towards a new phase based on diagnostic treatment. Discussions are currently being held with the Government regarding the future of HMM and planning for the project’s expansion to Integrated Community Case Management (ICCM), a strategy enabling assessment, treatment and referral of malaria and other childhood diseases such as pneumonia, diarrhoea and malnutrition.

 

© Y's Men International 1998-2012

Avenue Sainte Clotilde 9, CH-1205 Geneva, Switzerland