Brief Malaria Situation analysis

Malaria still remains a major public health concern for Malawi accounting for 40% of all patient deaths admitted in health facilities mainly affecting pregnant women and children. More than nine in every ten Malawians are aware of Malaria. This malaria high awareness, however, has not correspondingly demonstrated resultant improved malaria prevention and control behaviors as prevalence remain high at 33% resulting into not less than four million people being diagnosed and treated of malaria annually. Despite the recent recorded decrease in incident rate from 2010, by 2013, 230 Malawians per every 1000 population are diagnosed and treated of malaria and only 3 in 10 Malawians take action to treat malaria within 24hrs after the onset of fever.

Under malaria prevention, Malawi is yet to achieve universal coverage of ITNs. The Malawi DHS 2015-2016 estimates that only one in four household has at least one ITN for every two persons in the household. In all households where there are under five children in Malawi, only 45% of them sleep under an ITN and 47% of pregnant women sleep under an ITN in all households where there are pregnant women

In a country like Malawi where malaria transmission is high, by the time an individual reaches adulthood, she or he has acquired immunity to protect against severe disease, however pregnant women, especially those pregnant for the first time, frequently regain their susceptibility to malaria leading to mild or severe anaemia and interference with foetal exchange resulting into low birthweight infants. The 2014 MIS estimate that 90% of the pregnant women at least once received an antimalarial drug with the percentage decreasing to 64% for the pregnant women who had received two or more times an antimalarial drug during pregnancy. Generally, there is more access and utilisation of these malaria vector control interventions in urban than in rural areas confounded by levels of wealth quantiles.

Based on malaria morbidity, ONSE Health activity, is therefore, supporting the Malawi Government through the Ministry of Health to increase knowledge of malaria prevention and treatment in ten targeted districts including Mchinji as an output under intermediate result number four to increase demand for priority health services. This will be achieved through community level SBCC aimed at improving health seeking practices and behaviours and through community engagement to improve participatory processes for community empowerment to safeguard health.

Brief about Mchinji and malaria burden

Mchinji district has a population of over half a Million people with nine traditional authorities, four sub traditional authorities and 62 Group villages. The population is served by 17 health facilities. In relation to Malaria, last financial year, over 40,000 confirmed malaria cases were recorded with 106 of them dying as inpatients. The current district malaria action plan only has two activities mainly focusing on strengthening clinical skill in malaria case management and doesn’t outline efforts on community mobilisation and SBCC on Malaria prevention and control.

Project Introduction

PACHI, with support from USAID through Management Sciences for Health, is implementing a malaria social and behaviors change project in three traditional authorities in Mchinji district of Mduwa, Mkanda and Gumba. The aim is to contribute to the reduction of maternal, newborn and child mortality by increasing demand for quality health services through improved access and utilisation of malaria prevention and control services. This is meant to be achieved through initiation of community level SBC interventions that will result in communities with improved health seeking practices and behaviors but also through community engagement to improve participatory processes for community empowerment in order to safeguard health.

The Malaria Social Behaviour Change interventions are to embrace the Life stages approach by the Ministry of Health with the Messages either being adopted or adapted from the national malaria communication strategy which is a product of the national health communication strategy.