The World Bank Board of Directors today approved an International Development Association (IDA) grant of US$ 5 million for the Health Sector Support Project (HSSP), an additional grant to scale up activities in malaria monitoring and evaluation (M&E).Malaria accounts for 18% of all hospital deaths in Malawi and the entire population of 11 million is at risk of contracting malaria.
The additional grant is expected to improve management and decision-making and build capacity for M&E of the National Malaria Control Program (NMCP) and the Malawi Health Sector Wide Approach (SWAp). "While primarily targeting malaria, this grant also addresses the critical need to focus on results within the Health Sector", says Alfred Chirwa, Task Team Leader for the HSSP.
The grant is additional to the US$15 million that was approved in December 2004 for the HSSP. The objective of the HSSP is to improve the effectiveness, efficiency and quality of essential health care services, in particular those provided to the rural poor, women and children through: (a) improving human resources management and development; (b) ensuring the provision of an Essential Health Package (EHP); and (c) strengthening the EHP support and referral systems.
The Government of Malawi has a strong commitment to controlling malaria because of the significant negative impact it can have on achieving the aims of the SWAp program and the Millennium Development Goals. The 2001-2005 Malawi Malaria Strategic Plan made several advances in the areas of prevention and, based on its achievements to date, Malawi's NMCP has been acknowledged as one of the strongest programs in Sub-Saharan Africa. Malawi's new Malaria Strategic Plan (2005-2010) builds on the achievements of the previous five-year plan, and consistent with the Abuja Declaration and the Roll Back Malaria targets, aims to halve malaria mortality and morbidity by the year 2010.
However, the NMCP still faces several challenges and risks, including, inter alia, the severe human resource constraints that plague the entire health sector; increasing resistance of malaria parasites to Sulfaxodine Pyrimethamine (SP), the first line treatment for malaria in Malawi; problems in the supply of mosquito nets; inequities in access to malaria services; and persistent deficiencies in the M&E of the programmatic inputs, outputs and outcomes. "This grant will therefore assist Government in identifying deficiencies and successes to push the national malaria program forward," says Dr. Wesley Sangala, Principal Secretary in the Ministry of Health.
Malaria is the single most important public health problem in Malawi, accounting for 4 million cases annually. Since the entire population of 11 million is at risk, every citizen - especially rural women and children - is a potential beneficiary of a successful malaria control program. Malaria accounts for about 18 percent of all hospital deaths and 40 percent of the outpatient visits. Malaria's direct and indirect economic costs borne by individuals, households and government are huge. It is estimated that a large proportion of Malawi's workforce loses about 15-25 days a year due to malaria.
The additional grant will complement the significant resources from other development partners within the SWAp. On malaria specifically, this project will complement funding from discrete donors and pooled donors including funding recently approved by the Global Fund against AIDS, TB and Malaria (GFATM). The GFATM-approved proposal and the support provided by the SWAp partners address primarily the NMCP's service delivery requirements, whereas today's additional grant will address specifically the program's monitoring and evaluation needs.