Malaria remains a major public health concern in Malawi as the country on average annually records an estimated 6 million cases.
The disease remains a major cause of death especially in women and under 5 children with current statistics indicating that Malaria accounts for over 30% of outpatient visits and 34% of in-patients (HMIS 2018).
The disease does not only the burden families as it also affects the country’s productivity through high levels of expenditure for prevention and treatment.
It is for this reason that Humanitarian organisation World Vision Malawi has partnered with The Global Fund to Fight in working towards achieving Sustainable Development Goal (SDG) number 3 to ‘ensure healthy lives and promote well-being for all at all ages’, by reducing global maternal mortality, ending preventable deaths of new-borns and children under 5 by 2030.
Through the partnership World Vision Malawi is supporting the government of Malawi’s strategy on Integrated Vector Control which includes Long Lasting Insecticide Net (LLINS) distribution, Larvicide management and Indoor Residual Spraying (IRS).
From 2019 the organisation has been running a 5 year Indoor Residual Spraying-IRS campaign in 3 districts of Nkhatabay, Mangochi and Balaka which is expected to phase out in 2023.
However in Mangochi the campaign faced resistance at its initial stages with some community members alleging that the insecticides that are sprayed inside their houses affect the Human Reproductive system.
Now 4 years down the line there is some good news though as through various Social Behavioural Change interventions the community has now accepted the programme and the figures keep on rising as currently the acceptance rate stands at 95.1 percent.
‘At first indeed there was a lot of talk with some people instilling fear in us not to accept the campaign saying it results in women failing to conceive while men become impotent but as time went by we realised that the campaign is of our own benefit. As I speak I’ve benefitted from this campaign on 3 different occasions and I’ve never experienced any side effects. I am a married woman with 2 children and me and my husband we are living happily as husband and wife’, narrates 48 year old Catherine Winesi from Chisumbi Village T/A Chimwala in Mangochi who at the time of this narration was found outside her house as a World Vision Spray Operator was busy fumigating her house.
With the project targeting 3 hundred 41 thousand 7 hundred 92 structures, officials from World vision are optimistic that by the time the project winds up in end 2023, they would have at least reached out to 90% of the targeted structures if the rate they are going at now is to be maintained.
“We target to reach 341 792 structures by 2023 and currently we are at 203 000 structures representing 60% of the total targeted structures. From these targeted structures we intend to reach out to 1 million 181 thousand people and we are optimi9tic that we are going to reach out to that population’, explained Confidence Mkungula World Vision Project Coordinator for Mangochi district.
According to Mkungula apart from cultural beliefs, they also faced resistance due to religious beliefs but all that is now history after carrying out massive Social Behavioural Change interventions.
‘Upon noting strong resistance in the initial stages of the project, we intensified Social Behavioural Change interventions which among them included close engagement with traditional leaders whom we know that are custodians of the people and that has worked to our advantage’, said Mkungula.
Mkungula further went on to state that apart from focusing just on eradicating Malaria incidences, the project also has an element of economic empowerment as annually they are offering temporary employment to 1700 people.
‘This project also has an element of economic empowerment. We are empowering the communities we are working in by employing people within and outside. These temporary employees range from guards, cleaners, Spray Operators, Site Supervisors as well as Site Managers’, said Mkungula.
So being a project that is being run at a district level, how is World Vision coordinating with the District Commissioner’s office for the successful implementation of the project.
According to Raphael Piringu Mangochi District Commissioner, there has been cordial working relationship between the council and the organisation.
‘When we were rolling out the project we encountered several challenges ranging from cultural, religious and social misconceptions especially on the recruitment process. A lot of people thought that being a project that is being implemented in mangochi meant that only those people from the district would be employed under the Project but then as a council we had to call for a full council meeting where all stakeholders were briefed on the recruitment process as per Global Fund International guidelines and I’m pleased to report that since then we have never encountered any challenges with the recruitment process’, said Piringu.
According to Piringu since the project rolled out there has been remarkable improvement in disease burden as well as a significant drop in abortion cases due to Malaria to an extent that the district is having the luxury of Malaria drugs expiring as the disease burden is low.
‘Apart from 1 or 2 Traditional Authority areas where we are still encountering challenges due to other beliefs, I would say there has been positive response from community members in the district. World Vision as an implementing partner has been open and transparent in carrying out the project and that has helped to solicit feedback from the communities on areas we need to improve for the project to be a success’, said Piringu.
According to Piringu for instance through feedback from community members, they have been able to improve on the types of drugs that are being used to fumigate the houses as community members raised reservations with the previous drugs.
World Vision’s relationship with the Global Fund stretches back from 2017 when the children’s charity reached over 10.8 million people with a combination of Long-Lasting Insecticide Treated Nets, setting up of Village clinics and training of Health Surveillance Assistants and provision of Malaria Rapid Diagnostic Testing Kits.
It follows Studies in the country which established that primary school children are vulnerable to the effects of malaria, which can cause untimely deaths among them. For instance in 2020 alone, Malawi recorded about 7 million malaria cases that claimed 2,500 lives.
Within the first year of World Vision’s Interior Residual Spray intervention, staff sprayed 516,225 homes across the three districts where the project is being implemented.