Zambia National Malaria Indicator Survey (MIS) 2010

Welcome!!

The Barn MotelLusaka

MIS 2010

• You are here for training and participating in a national household survey to measure progress in malaria prevention and control services

• We will spend 1 week training and then will spend about 6 weeks carrying out the survey in all parts of Zambia

Why conduct a household survey?

National Malaria Strategic Plan 2006-2010

• A malaria ‘free’ Zambia

• Scaling up for impact– Focus on prevention during scale up– Improving diagnosis and care

• Effective program management

• Empowering individuals and communities

• Commitment to M&E

Priority malaria interventions

• Case management– with ACTs (Coartem©) as first line treatment

and improvements in diagnostic services using microscopy and RDTs

• Prevention– Insecticide-treated mosquito nets, now

exclusively LLINs– Indoor residual spraying (IRS) in 15 mainly

urban districts, expanding to 22+ in 2008– Prevention of malaria in pregnancy, including

IPT(SP) and ITNs

Reminder: Targets and Goals

National Strategic Plan 2006-2010• a reduction of malaria incidence by 75% and deaths due to

malaria will be significantly reduced by the end of 2011• a reduction of all cause mortality by 20% in children under five

Abuja Targets 60% 80% 100%• At least 80% of those suffering from malaria should be able to

access and use correct, affordable and appropriate treatment within 24 hours of onset of symptoms.

• At least 80% (or 85%) of those at risk of malaria, particularly pregnant women and children under 5 years of age, should benefit from suitable personal and community protective measures such as ITNs.

• At least 80% of all pregnant women who are at risk of malaria, especially those in their first pregnancies should receive IPT

Background

• Zambia MIS 2010 objectives:

– To collect up-to-date information on Coverage of Core interventions in NMSP (2006-2010) to guide planning and implementation.

– Assess malaria parasite prevalence according to the standardized RBM MERG recommendations;

– Assess the status of anaemia among the target populations (children 6-36 months) according to the RBM MERG recommendations;

– Strengthen the capacity of the NMCC and local agencies in implementation of malaria surveys.

Tools/Techniques

• Personal Digital Assistants (PDAs)– Household listing– Questionnaires

• Malaria parasite and anaemia testing– Hemocues– Rapid Diagnostic Tests (RDTs)– Malaria blood slides– Filter papers/blood spots

PDAs / GPS

• Two critical advantages– Time saving: 1) In one field visit, both

the 2nd stage household selection and interviewing conducted 2) combining multiple team member HH listings

– Highly efficient at data processing• One important disadvantage

– If the programming is not correct, BIG potential source of error

• FYI: gadgetry, importation, available pool of PDAs, software development, lessons learned (Windows Mobile 5, VB vs. Visual CE)

Logistics

• Training: 24 March -31 March– Facilitated by NMCC, WHO, MACEPA, HSSP,

UNZA, PMI, MTC • Field work: 1 April- first week of May• Survey teams included:

– 15 Field Teams (national sample)• 2 nurses from surveyed districts (MoH), 2 lab

techs/microscopists, CSO, 1 driver– ~32 people involved in focused survey in

Luangwa/Nyimba district• created from select UNZA MPH students

– Several participants for IVCC survey (Emanuel Chanda-NMCC, Mike Coleman, MRC Durban)

Research Ethics Approval

• University of Zambia

• Centre’s for Disease Control and Prevention for PMI

• PATH (for MACEPA)

• Consent for participation, finger sticks/testing and women’s questionnaire

Sensitization

• MoH, CSO, partners

• MoH Province Districts facilities CHW chiefs/headmen communities

• Community radio stations