Training Manual Use of Rectal Artesunate as a Pre-Referral Intervention for Severe Malaria at Community Level

Malaria incidence rates among children are very high in many rural districts of Zambia. Every year, many children die when their malaria progresses to severe malaria because they have not received appropriate or timely treatment. Many of these deaths could be avoided if communities were effectively mobilised around a child health agenda and if WHO-approved rectal artesunate (RAS) – a life-saving pre-referral treatment – were readily available at community level.

Children also suffer and sometimes lose their lives because of delayed identification of other common childhood illnesses. These include severe diarrhoea and acute respiratory infection (ARI). Gaps in knowledge of the danger signs for all these illnesses, and household and community barriers and delays that prevent prompt referral of children are responsible.

This training manual outlines a two-part training approach that can be used to:

Train selected Community Health Volunteers (CHVs) to recognise and administer severe malaria in young children using rectal artesunate (RAS)

Train communities to respond promptly and appropriately to severe malaria, and to other common childhood illnesses

Increasing children’s access to life-saving treatment for severe malaria and other common childhood illnesses requires community members who can identify danger signs and know how to respond, and CHVs who can support and refer patients to the health facility. Both groups need to be trained.

Please click below to read the full training manual.

Emergency Transport Scheme (ETS) Training Guide for Trainers of Bicycle Ambulance (April 2019)

Emergency Transport Schemes (ETS) offer an affordable means of transportation for health emergencies and patient referrals to health facilities, in communities where no formal transport services exist, or where affordable means of transportation lack.

This training manual is intended for trainers who are conducting training on ETS, and introducing bicycles as a solution for community based transport to help expecting mothers and under 5 children with severe malaria in accessing health care when in labour and six weeks after child birth. The topics in this manual have been logically arranged to help guide the trainer follow an approach which aims to maximise the impact of the ETS introduction through clear messaging and instruction.

 The purpose of the ETS training is to develop the knowledge and skills of the community volunteer ETS riders so that they can professionally, safely, actively and effectively contribute to reducing the delay on maternal emergencies and children with severe malaria faced in accessing transportation. This manual acts as a learning tool and reference to be used in conducting training geared towards achieving this. It contains the course layout, proposed timings and gives the trainer comprehensive guidance on critical issues relating to the successful operation of a community managed ETS. It is not meant as a document for general distribution among all ETS volunteer riders, rather for trainers.

Please click below to read the full guide.

Study on Gender Empowerment Outcomes in MAM@Scale Intervention Sites

This report is a study on empowerment outcomes undertaken on behalf of the MAMaZ Against Malaria At Scale project (MAM@Scale). The study looked at the extent to which women and girls in the project’s intervention sites had transitioned from a situation where they had limited power to one where they could challenge power inequalities and access new opportunities for development.

The study was undertaken in December 2019. This was an internally commissioned study, designed and led by a MAM@Scale Senior Technical Adviser who worked alongside the project’s technical team in the project’s two core intervention districts: Chitambo and Serenje in Central Province.

In the project intervention sites a number of gender empowerment-related gains were evident. The extent of change varied depending on the length of time trained CHVs and ETS riders had been active in the community.

The seven ‘gender-smart’ strategies that comprise MAM@Scale’s gender empowerment approach were integral to driving the empowerment gains achieved by the project. There are lessons here for other interventions wishing to achieve empowerment-related outcomes that extend beyond health.

Please click below to read the full report.

WHO Bulletin: Use of rectal artesunate for severe malaria at the community level, Zambia

The World Health Organisation (WHO) has reported on a Transaid project in Zambia, which has helped to dramatically reduce severe malaria mortality in children under six years of age, as being “feasible, safe and effective in hard-to-reach communities”. In this official report, the WHO research bulletin identifies the project’s approach – which included a bicycle ambulance system implemented by Transaid – as being highly adaptable, stating it “could be used in other countries with a high malaria burden”.

Zambia’s Health Minister, Dr Chitalu Chilufya, has also praised the success of the pilot. Speaking during the Global Fund’s Sixth Replenishment Conference in Lyon, France, attended by heads of state, heads of government, philanthropists and NGOs, he reinforced the need for partnership to ensure that pre-referral anti-malarial treatments could be financed and rolled out at national level.

Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes; and is highly prevalent in young children. Despite it being preventable and curable, the WHO African Region carries a disproportionately high share of the global malaria burden – being home to 92 per cent of malaria cases and 93 per cent of malaria deaths in 2017.

Transaid worked on the initial pilot project (MAMaZ Against Malaria) in Serenje District with Medicines for Malaria Venture (MMV) between 2017 and 2018, in collaboration with a consortium of partners which included DAI Global Health (formally Health Partners International), Development Data, Disacare, the Zambian National Malaria Elimination Centre and District Health Management Team. Following its success, this year Transaid became part of a scale-up programme, securing matched funding from Grand Challenges Canada and the Government of Canada to enable the initial project to quadruple in size, potentially benefiting as many as 250,000 people in rural Zambia by the end of 2020.

The WHO research focused on a 12-month period during the pilot, using data from three sources including surveys carried out near the beginning and end of the intervention period, health facilities contributing data on malaria to the Zambia Health Management Information System and a community monitoring system. It also collected qualitative data via case studies, feedback from government officials and reports of informal discussions with community health volunteers and communities.

In the year before the intervention, 18 deaths occurred in 224 cases of confirmed severe malaria among children younger than five years of age seen at intervention health facilities (case fatality rate: 8%). During the intervention, three out of 619 comparable children with severe malaria died (case fatality rate: 0.5%).

To read the full report, please click below.

Developing innovative approaches to increase rural access to commodities for the case management of severe malaria in Zambia: Final Project Report (August 2018)

This final report presents the key results from the MAMaZ Against Malaria (MAM) project which was established in July 2017.

MAMaZ against Malaria is a one year pilot project, funded by the Geneva-based foundation, Medicines for Malaria Venture (MMV). The project aims to devise an evidence-based and sustainable strategy to improve the access of hard-to-reach communities to effective treatment for severe malaria (SM) in a high malaria burden setting.

The project is being implemented by a consortium led by Transaid in partnership with Health Partners Zambia, Development Data and Disacare. The consortium is working in partnership with the Ministry of Health in Zambia, specifically the National Malaria Elimination Centre, and the District Health Management Team for Serenje District.

To read this report, please click below.

MAM evidence brief – key results

This technical brief presents the key results from the MAMaZ Against Malaria (MAM) project which was established in July 2017.

MAMaZ against Malaria is a one year pilot project, funded by the Geneva-based foundation, Medicines for Malaria Venture (MMV). The project aims to devise an evidence-based and sustainable strategy to improve the access of hard-to-reach communities to effective treatment for severe malaria (SM) in a high malaria burden setting.

The project is being implemented by a consortium led by Transaid in partnership with Health Partners Zambia, Development Data and Disacare. The consortium is working in partnership with the Ministry of Health in Zambia, specifically the National Malaria Elimination Centre, and the District Health Management Team for Serenje District.

To read this report, please click below.

MAMaZ for Malaria (MAM) dissemination event in Zambia

The event brought together various stakeholders to present findings from the MAMaZ against Malaria (MAM) pilot programme which ended in July, 2018. The event  was hosted by the National Malaria Elimination Centre (NMEC) and results were shared from the project ‘Developing innovative approaches to increase rural access to commodities for the case management of severe malaria in Zambia’.

The initiative was implemented in close partnership with the Ministry of Health (MOH) and Serenje District Health Management Team (DHMT) and was funded by Medicines for Malaria Venture (MMV), who also provided ongoing technical support. To read more about the MAM programme, please click here.

To download the presentations, please click below.

MAMaZ Against Malaria (MAM) Mid-Term Report

This mid-term report presents progress from the start of the MAMaZ Against Malaria (MAM) project in July 2017 until January 2018.

MAMaZ against Malaria is a one year pilot project, funded by the Geneva-based foundation, Medicines for Malaria Venture (MMV). The project aims to devise an evidence-based and sustainable strategy to improve the access of hard-to-reach communities to effective treatment for severe malaria (SM) in a high malaria burden setting.

The project is being implemented by a consortium led by Transaid in partnership with Health Partners Zambia, Development Data and Disacare. The consortium is working in partnership with the Ministry of Health in Zambia, specifically the National Malaria Elimination Centre, and the District Health Management Team for Serenje District.

To read this report, please click below.

 

Introducing MAMaZ Against Malaria (MAM)

Transaid and Swiss foundation, Medicines for Malaria Venture (MMV) are joining forces and working in collaboration with the National Malaria Elimination Center (NMEC) of Zambia, to develop innovative approaches to improve severe malaria case management in rural areas.

The project aims to address the lack of access to quality severe malaria treatment commodities and case management in Serenje District, Central Province, Zambia, which has high malaria prevalence rates. This flyer details the approach taken, early results and achievements so far. As in the MAMaZ programmes, rural emergency transport systems are  being strengthened in the intervention district.

To view the flyer, please click below.

H17. Training manual on community based pre-referral treatment for severe malaria

 

Increasing children’s access to life-saving treatment for severe malaria and other common childhood illnesses requires community members who can identify danger signs and know how to respond, and CHVs who can provide pre- treatment.  This manual builds on  work from our previous programme in Zambia, More MAMaZ (2014-2016) see here, and applies the same approaches for our currently ongoing MAMaZ Against Malaria (MAM). To read more about MAM, please click here.

This training manual outlines a training approach that can be used to:

  • Train selected Community Health Volunteers (CHVs) to diagnose and pre-treat severe malaria in young children using rectal artesunate (RAS)
  • Train communities to respond promptly and appropriately to severe malaria, and to other common childhood illnesses

Click below for the training manual

Transforming Rural Access: motorcycles, low cost infrastructure and appropriate standards

On the 9th of May 2017 Transaid facilitated a workshop on ‘Transforming rural access: motorcycles, low-cost infrastructure and appropriate standards on behalf of ReCAP at the 8th Transportation Technology Transfer Conference in Zambia. In many countries motorcycles and motorcycle taxis are the most common vehicles and may account for 75% of passenger and freight transport on Low Volume Rural Roads. ReCAP has funded recent research on motorcycle taxis and recently organised a webinar on motorcycles, which was attended by people from 24 different countries. The Transportation Technology Transfer (T2) conference was therefore an excellent opportunity to build on the momentum of these activities and facilitate discussion and dissemination on this important topic.

This report describes the context of the workshop, the discussions that took place as well as future recommendations. See below.

Further information about the presentation can be found here

Transaid presentation on ‘Transforming Rural Access: Motorcycles, low cost infrastructure and appropriate standards’ at the T2 conference in Zambia

Transaid presented at the 8th Africa Transportation Technology Transfer (T2) conference, which was held in Livingstone Zambia from the 8th to 10th of May, 2017 courtesy of Research for Community Access Partnership (ReCAP). The theme for the conference was: ‘Linking Africa through Sustainable Transport Infrastructure Development’

The overall objective of the UK Aid funded ReCAP  is to improve accessibilty of the rural poor in Africa and Asia to economic opportunities and social facilities through improvements to infrastructure and transport.

This is a forum intended to share, exchange and debate experiences, best practices and new technologies in the provision, maintenance and management of all modes of transport. Part of the presentation is based on findings from Transaid’s ReCAP funded Boda boda webinar held on the 6th of April, 2017 on the topic of ‘Motorcycle taxis in a Rural Context in Sub-Saharan Africa and South Asia.’ To read more click here.