IRS key to combating malaria - Raphaka

Chandapiwa Baputaki | 25 Aug 2009
Mmegi (Gaborone)
The Permanent Secretary in the Ministry of Local Government, Thato Raphaka has said it is critical to continue to focus on malaria vector control activities through Indoor Residual Spray (IRS) so that 80 percent coverage is achieved as recommended by the World Health Organisation (WHO).

Raphaka was speaking at the signing of the Malaria Programme Review Aide-Memoir at Phakalane Golf Estate last Friday. He said that this would entail providing necessary resources for spray teams to spray and finish the exercise within the stipulated period as well as strengthen supervision of these teams. "I can assure you that we are committed to this course of action," Raphaka said.

He asserted that the use of Long Lasting Insecticides Treated Nets (LLINs) is also a good strategy for the reduction of malaria transmission. "Hence the Ministry of Local Government, in partnership with the Ministry of Health and indeed other partners will continue to provide free nets in Zone A in order to increase coverage and usage. We will also endeavour to appoint malaria district coordinators particularly in Zone A for purposes of effective implementation of the recommendations of this review," he said.

The permanent secretary further stated that they appreciate that community mobilisation in malaria control is a key component in the quest for success. In this regard, he said, there would be a concerted effort to empower health education officers in the districts to ensure that community acceptance of malaria control interventions is attained.

"Through the signing of the Aide Memoire, we have re-affirmed our commitment for dealing with the malaria problem. I therefore wish to extend our thanks to our development partners for their assistance in many different ways. I can only hope that we shall continue to cooperate, collaborate and indeed consolidate our efforts with major, determination and true commitment to ultimately eliminate malaria by year 2015 and hopefully attain our vision pillar on a prosperity for all by year 2016," he said.

Health permanent secretary Newman Kahiya said the Aide-Memoire will open a new page in Botswana as the information gathered will re-define the specific direction of the programme. He said the government has committed resources with the aim of eliminating malaria from the country. "Clearly, the Botswana government has to develop and endorse a comprehensive malaria elimination policy with a strategic framework and action plan," Kahiya said.

According to the team leader of the survey Dr Loeto Mazhani, in April last year, government decided to undertake an in-depth review of the national malaria control programme. He explained that this decision was made in the context of the observed decline in malaria incidence, deaths and epidemics in all malaria risk zones of Botswana and improving coverage of interventions, goals for universal access to effective interventions to achieve Millennium Development Goals (MDG) targets. Mazhani noted that the other objective was to review malaria epidemiology in Botswana, to review the policies and programming framework within the context of the health system and the national development agenda, to assess the progress towards achievement of national, regional and global Roll Back Malaria and United Nations (UN) MDG targets and to review the current programme service delivery systems, their performance and challenges.

The team recommended that there should be an increase in production and dissemination of malaria IEC materials based on local information and an increase in the budget for malaria advocacy and IEC to support malaria elimination. They recommended that Rapid Diagnostic Therapy (RDT) be adopted as the primary malaria diagnostic tools in all health facilities and guidelines be developed by 2010 to follow up confirmed malaria cases and contact tracing to eliminate the parasite. It was also recommended that a national malaria reference laboratory with capacity for molecular and serological analyses and conduct quality control and assurance for malaria diagnostics be established in the country.

On the surveillance, monitoring and evaluation, the team recommended that malaria cases be mapped by health facilities to update the classification of malaria transmission risk at district and sub-district levels, and to target interventions to malaria hotspots while standard operating procedures for case based notification and investigation of all malaria confirmed positive cases are introduced. Operational research areas and strengthening the partnership for research should also be prioritised, the experts said.

On programme policies and management, the team recommended that the staff of the National malaria elimination programme (NMEP) should be increased and reconstitute of the malaria reference group to provide guidance towards malaria elimination by 2013.

They recommended that one policy document for malaria elimination be developed and linked with the new national health policy. "Involve the private sector in the malaria elimination activities. MOLG should also designate district malaria elimination coordinators in Zone A, establish a malaria elimination field centre in Maun, and develop a costed malaria elimination strategic plan that is linked to NDP 10 (2010-2016)."