progress and challenges towards eliminating malaria in afghanistan
DESCRIPTION
TRANSCRIPT
Progress and challenges towards eliminating malaria in
Afghanistan
Najibullah Safi, MD, MSc. HMP, DMPPMNational Malaria and Leishmaniasis Control Program
Manager MoPH - Afghanistan
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 2
Malaria Transmission in Afghanistan
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 3
Anti Malarial Treatment in Health Care System of Afghanistan
Health post (HP) Basic health center (BHC) Comprehensive health center District hospital Provincial hospital Specialized hospital
Clinical MalariaClinical MalariaClinical MalariaClinical MalariaClinical MalariaClinical Malaria
Confirmed Malaria
Clinical Malaria
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 4
Achievements
Health care system cover 82% of the population Formulation of policies and guidelines
– National strategic plan– National treatment protocol (adopting ACT for
confirmed PF)– Epidemic preparedness and response– Malaria microscopy for lab technicians– Diagnosis and treatment of sever complicated
malaria– Treatment guideline for community health workers– National IVM strategic plan– Addition of malaria into school curriculum
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 5
Achievements cont.
Establishment of 14 quality assurance centers
Improvement in reporting system– 980 health facility report malaria cases– 8000 health posts (16000 CHWs)– Piloting the Global Malaria Database
Training– Public (including BPHS implementing NGOs) – Private (lab technicians, MDs, pharmacist…)
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 6
Achievements cont.
GFATM (R5) approved 2.1 million LLINs over 5 years
In current year more than 300,000 LLINs distributed in target provinces
Construction of new building for headquarter of the program and research and training institute
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 7
Achievements cont.
Vector surveillance – Entomology unit established in NMLCP
• Plan to establish three Vector Control units in provinces
Regular monitoring of anti-malarial drugs since 2003– Results up-to-date show 100% ACPR
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 8
Achievements cont.
Trend of Malaria 2002 – 2006
0
100000
200000
300000
400000
500000
600000
700000
2002 2003 2004 2005 2006
Years
Nu
mb
er
of
Re
po
rte
d C
as
es
Malaria reported cases
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 9
Challenges
Insecurity Scarcity of resources
– Financial– Human
Lack of motivation Fragmented health care system Poor coordination among stakeholders Gratuitous interference Time-consuming bureaucratic channels
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 10
Challenges cont.
Geographical, economical and cultural barriers affecting easy access to facilities with laboratory services (CHC and DH)
Absence of lab facility in HP and BHC– On average 1.5 lab/district exist to provide
a multitude of tests including malaria Reduction in proportion of confirmed
cases over the years
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 11
Challenges cont.
61.6
19.4
0
10
20
30
40
50
60
70
2003 2006
Year
% o
f co
nfi
rmed
cas
es
Proportion of confirmed cases
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 12
Challenges cont.
Unregulated private sector Wide practice of self medication Sustainability of the program
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 13
Prospects
Future of malaria control is promising – Financial support from GF (Round 5)
• Plan to apply for the next round of GF
– Political commitment – Enhanced technical support and better
cooperation with WHO– Piloting RDT in three WHO CBI/BDN projects– Upcoming cross border project with
Tajikistan
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 14
Prospects cont.
– Establishment of new health facilities (sub-centers) under GAVI fund for strengthening health care system
– Establishment of 18 sentinel sites to monitor the trend of malaria in high risk provinces
– Establishment of malaria advisory board (enhanced coordination)
– Incentives for the staff from GF– Changes in program leadership
WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 15