MAMaZ Against Malaria at Scale: Midline Survey Report

The MAM@Scale project is a scale up of the pilot project which was carried out in Serenje district between July 2017 and July 2018. The main objective of conducting the midline review was to gauge progress to date of the MAM@Scale activities. The results in this report reflect progress part way through implementation of the project (the current phase of the project ends on 30 November 2020). The review was carried out in selected project areas to review progress in achievements and assess the possible change that can be attributed to the project, particularly with regards to management of cases of severe malaria. The review was conducted in June and July 2020.

Click below to read the full report.

Results of a community-driven intervention in rural Zambia to reduce child mortality – Evidence Brief

As the global development agenda converges around the Sustainable Development Goals (SDGs) and aims for Universal Health Coverage (UHC), there is much emphasis on the need for an inclusive development approach. To achieve this, communities need to be at the centre of interventions and must have the knowledge and resources to drive their own development agenda according to their local needs. However, in rural Zambia, as in many other sub-Saharan African contexts, communities continue to face multiple barriers in accessing basic services. Underlying factors include geographical, financial and social constraints.

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Importance of gender empowerment to reducing malaria mortality in Zambia – Evidence Brief

Gender equality and women’s empowerment are key to achieving universal health coverage. They are also important in their own right as a means to achieve sustainable development. Building on a successful gender mainstreaming approach used in three earlier projects, MAM@Scale integrated a focus on gender into the design of a severe malaria intervention in Zambia. Community health volunteers (CHVs) were trained to administer quality assured 100 mg rectal artesunate to children with severe malaria danger signs at community level and to refer patients to the health facility for further treatment. The project’s gender strategy aimed to address the wide range of social norms and gender stereotypes that prevented rural households from responding promptly to severe malaria and other child health emergencies.

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Adapting a severe malaria intervention in Zambia in the context of COVID-19 – Evidence Brief

In early March 2020, coronavirus (COVID-19) was declared a pandemic by the World Health Organization. Many countries had started to take steps to isolate suspected cases, ban mass gatherings and public events, close schools and universities and impose social distancing. At the time, MAMaZ Against Malaria at Scale (MAM@Scale) was implementing a community level intervention to address severe malaria targeted to young children in five districts of Zambia, working in partnership with district health teams. Responding to an urgent request by the Ministry of Health (MOH) for development partners to help build community preparedness and resilience, the project swiftly pivoted its activities to integrate a COVID-19 focus.

This evidence brief looks at how MAM@Scale adapted a severe malaria intervention in Zambia in the context of COVID-19.

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Scaling up rectal artesunate in Zambia – Evidence Brief

Over 7,500 malaria deaths occurred in Zambia in 2018 and children under six are the most susceptible due to their lack of immunity. MAM@Scale empowered Zambian families in five districts (Chitambo, Serenje, Chama, Manyinga and Vubwi) to reduce their mortality risk from severe malaria by introducing artesunate rectal capsules (known locally as rectal artesunate or ‘RAS’), a cutting-edge pre-referral intervention given at community level to children aged six months to six years old. The MAMaZ Against Malaria (MAM) pilot project (2017-2018) reported a reduction in severe malaria case fatality from 8% to 0.25% in intervention sites in Serenje district.

Building on this evidence base, MAM@Scale began implementation in December 2018 with funding from Grand Challenges Canada, Medicines for Malaria Venture and Transaid. Originally an 18-month intervention, additional funding from FIA Foundation, Grand Challenges Canada and a private donor extended the project by six months and enabled the inclusion of a COVID-19 focus. MAM and MAM@Scale built on a longer-term investment in community health systems strengthening by two earlier projects.

This evidence brief looks at scaling up progress so far and highlights some key lessons to guide wider national scale up of the innovation.

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Case study: Chitambo District Health Office (DHO) partnering with MAM@Scale in the COVID-19 response

The collaboration between Chitambo District Health Office (DHO) and MAM@Scale has been very effective, not only in the treatment of severe malaria at community level using rectal artesunate, a pre-referral drug, but also developing strong preventative measures against COVID-19 in this transit town.

MAM@Scale uses a strong community engagement approach by establishing and strengthening community systems to uplift health standards at community level. It is an inclusive approach that engages people at all levels, from traditional leadership to members of the community. People who volunteer to work for the community are trained in health education and become the providers of basic health services at community level. Food banks and savings schemes are formed in the communities to fight affordability barriers. This has not only raised demand for health services in the facilities that MAM@Scale is supporting in Chitambo district, but it made it much easier to put up preventative measures against COVID-19.

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Case Study: Baron educates people on malaria, emergency transport systems and COVID-19 on air

Fwanta is a community in the Kabamba area of Serenje District, Zambia.  In the past, many people in Fwanta who developed medical complications, be it maternal or malarial related, died because people wrongly interpreted the danger signs.

A turning point happened when MAMaZ Against Malaria at Scale (MAM@Scale) began working with this community and the Kabamba Rural Health Centre. They trained Community Health Volunteers (CHVs) on the management of severe malaria at community level through the administering of a Rectal Artesunate Suppository (RAS). MAM@Scale also provided an emergency transport system (ETS), in the form of a bicycle ambulance, to Fwanta.  Baron Mupeta was one of the people selected to be trained as an ETS rider.

Click below to read Baron’s testimonial.

Case Study: Brenda Kundo

Community Health Volunteers (CHVs) are the backbone of the health system in rural Zambia, where they provide invaluable health advice to their communities, which are located prohibitively far from health facilities. Before the pandemic, CHVs were a vital part of our MAM at Scale programme, combatting malaria in their community by educating families on the danger signs of severe malaria and administering RAS (rectal artesunate suppositories), a pre-treatment for children with suspected severe malaria.

CHVs are a trusted voice in their communities, so it was natural that they would form the cornerstone of MAM at Scale’s COVID-19 response. To meet the challenges of the pandemic, the MAM at Scale team has orientated nine Community Facilitators on COVID-19, who have in turn trained 1,379 CHVs, who will help keep their communities safe during the pandemic.

Brenda Kunda is a Community Facilitator with MAM at Scale. A tragic experience in Brenda’s life eventually led to a positive change, not only for her, but for her family and her entire community.

Click below to read Brenda’s story.

Article – How MAM@Scale adapted to tackle COVID-19 whilst maintaining momentum in the fight against malaria

2020 marked the start of the Decade of Action on Sustainable Development, which aims to accelerate progress towards achieving the UN Sustainable Development Goals by 2030. However, this year also saw the emergence of a new coronavirus disease, COVID-19, which has had devastating effects on health systems globally and has the potential to put a halt to much of the progress made against specific Goals. This global pandemic also poses a serious threat to the broader social, economic, and political security of entire populations worldwide, disproportionately impacting communities in low-income countries and resource-constrained settings.

In the wake of the pandemic, the MAM@Scale programme had to quickly and effectively adapt in order to tackle the spread of COVID-19 while continuing the fight against severe malaria as well as other lifesaving work to enhance maternal health outcomes. Thanks to funding from the FIA Foundation for the Automobile and Society, together with Grand Challenges Canada and MMV, we were able to integrate COVID-19 prevention into our work and support the government of Zambia’s COVID-19 response.

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MAM@Scale COVID-19 Response: Revised RAS Protocol

Since the Covid-19 outbreak, many have faced unprecedented challenges around the world. Like many organisations, Transaid has been adapting and finding new ways of working, and making sure that all staff, consultants and volunteers are protected and safe. Consequently, Transaid has been working to introduce new protocols and ways of working for our colleagues in the field.

As part of this, Transaid have been focusing on awareness raising, establishing hand washing stations and topping up the community food banks as part of the preparedness planning in the MAM@Scale intervention sites in Zambia. This also included the development of materials aimed at supporting awareness raising activities, and to ensure that the people on the frontline of project operations, as well as the people they are supporting, are safe and protected at all times.

Please click below to view the updated rectal artesunate (RAS) protocols for Community Health Volunteers (CHVs), in English, Chewa, Senga, and Luvale.

MAM@Scale COVID-19 Response: Signs and Symptoms Poster

Since the COVID-19 outbreak, many have faced unprecedented challenges around the world. Like many organisations, Transaid has been adapting and finding new ways of working, and making sure that all staff, consultants and volunteers are protected and safe. Consequently, Transaid has been working to introduce new protocols and ways of working for our colleagues in the field.

As part of this, Transaid have been focusing on awareness raising, establishing hand washing stations and topping up the community food banks as part of the preparedness planning in the MAM@Scale intervention sites in Zambia. This also included the development of materials aimed at supporting awareness raising activities, and to ensure that the people on the frontline of project operations, as well as the people they are supporting, are safe and protected at all times.

Please click below to see the “Signs, Symptoms and Response” Posters in English, Bemba, Chewa, Senga, and Luvale.

MAM@Scale COVID-19 Response: Prevention Poster

Since the COVID-19 outbreak, many have faced unprecedented challenges around the world. Like many organisations, Transaid has been adapting and finding new ways of working, and making sure that all staff, consultants and volunteers are protected and safe. Consequently, Transaid has been working to introduce new protocols and ways of working for our colleagues in the field.

As part of this, Transaid have been focusing on awareness raising, establishing hand washing stations and topping up the community food banks as part of the preparedness planning in the MAM@Scale intervention sites in Zambia. This also included the development of materials aimed at supporting awareness raising activities, and to ensure that the people on the frontline of project operations, as well as the people they are supporting, are safe and protected at all times.

Please click below to see the “COVID-19 Prevention Poster”,  in English, Bemba, Chewa, Senga, and Luvale.