This is a two and half year program implemented in west Nile and Luwero triangle in Uganda. The project covers the15 districts of Koboko, Yumbe, Maracha, Arua, Nebbi, Pakwach, Luwero, Moyo, Zombo, Adjumani, Nakasongola, Nakaseke, Kyankwanzi, Kiboga and Madi-Okollo at a budget of Ugx7,030,259,833. The project is implemented in partnership with The AIDS support organization (TASO) as the principal recipient of the global fund and the government of Uganda. Project intervention areas and Program objectives includes; to build the capacity of private sector health workers through training in integrated management of malaria (IMM), health management information systems (HMIS) and supervision for private sector reporting by 2020 and to strengthen community response and participation in malaria control in 14 districts by 2020.

Background

According to the latest World Malaria Report, released in November 2017, there were 216 million cases of malaria in 2016, up from 211 million cases in 2015. The estimated number of malaria deaths stood at 445 000 in 2016, a similar number to the previous year (446 000).

The African Region continues to carry a disproportionately high share of the global malaria burden. In 2016, the region reported 90% of malaria cases and 91% of malaria deaths. Some 15 countries – all in sub-Saharan Africa, except India – accounted for 80% of the global malaria burden.

In areas with high transmission of malaria, children under 5 are particularly susceptible to infection, illness and death; more than two thirds (70%) of all malaria deaths occur in this age group. The number of under-5 malaria deaths has declined from 440 000 in 2010 to 285 000 in 2016. However, malaria remains a major killer among children under five years old, taking the life of a child every two minutes.

Uganda has the third highest number of Plasmodia falciparum infections in sub-Saharan Africa, and some of the highest reported malaria transmission rates in the world. There is stable, perennial malaria transmission in 90–95% of the country. According to 2015 data from Uganda’s Health Management Information System (HMIS), malaria accounts for 34% (monthly range, 29–39%) of outpatient visits and 28% (monthly range 21–39%) of hospital admissions. Of all the reported malaria cases in 2015, an average of 55% was laboratory confirmed, although this average increased to 64% between July and December (Uganda Malaria Operational Plan 2017).

Malaria remains one of the most major diseases in Uganda, causing significant morbidity, mortality and negative socio-economic impact. Children under age 5 and pregnant women are at high risk because of low immunity against the disease. Hospital records suggest that malaria is responsible for 30 to 50 percent of outpatient visits, 15 to 20 percent of admissions, and 9 to 14 percent of inpatient deaths (NMCP, 2014/2015)

The Global Fund to fight HIV/AIDS, Tuberculosis and Malaria (GFATM) has supported Uganda’s fight against the HIV/AIDS, Tuberculosis and Malaria Epidemic since 2002.The Global Fund grants support priority areas in the Strategic Plans for HIV/AIDS, Tuberculosis and Malaria and also National Priorities of building resilience Health and community systems for delivery of quality services. The country wrote concept notes requesting GF to fund specific areas of the disease strategic plans. Uganda was awarded three grants, implemented by 2 PRs, namely:- MoFPED and TASO (direct recipients of funds from GF and accountable on behalf of the government of Uganda).

Methodology

The program is implemented in partnership with TASO, district health teams and district based CSOs.

All activities are jointly planned and implemented. The District Health Teams are responsible for scheduling activities to fit in the district specific activities, mobilization of participants, supervision, monitoring and evaluation. Data collected is shared and reported through HMIS to DHIS2.

Specific Program Objectives

1:To build the capacity of private sector health workers through training in integrated management of malaria (IMM), health management information systems (HMIS) and supervision for private sector reporting in 15 districts by 2020 .

2: To strengthen community response and participation in malaria control in 14 districts by 2020.

Program activities

• Training of private health workers in integrated management of malaria private sector in Yumbe, Koboko, Maracha, Arua, Madi-Okollo, Nebbi, Pakwach, Moyo, Adjumani, Zombo Luwero, Nakaseke, Kyankwanzi, Nakasongola and Kiboga Districts.
• Training of health workers in routine health management formation system HMIS reporting in Yumbe, Koboko, Maracha,  Arua, Madi-Okollo, Nebbi, Pakwach , Moyo, Adjumani,  Zombo, Luwero, Nakaseke, Kyankwanzi, Nakasongola and Kiboga Districts
• Support supervision of private sector for reporting:
• To scale up implementation of ICCM to Koboko, Yumbe, Maracha, Arua Nebbi, Pakwach, Madi-Okollo and Luwero Districts by 2020.
• Orient DHMT (District trainers) on the new ICCM/HIV/TB guidelines:
• Orientation of village health team supervisors on the new ICCM/HIV/TB guidelines.
• Quarterly supervision meetings for VHTs:
• Conduct supply chain support for ICCM consumables.
• Conduct quarterly supervision and review meetings for VHTs:
• Support quarterly supportive supervision; DHMT to health facilities
• Reprinting and distribution of MOH and TASO approved ICCM data collection tools
• Facilitate Malaria talking points in clergy programs (regional levels).
• Facilitate Malaria talking points in clergy programs (district levels).
• Re orientation of VHTs and malaria parish champions on malaria SBCC
• VHTs and Malaria parish champion home visits to mobilize communities towards better preventive measures.
• Conduct community dialogue meetings at community level

Expected Program Outcome

1: Enhanced Capacity of Private Sector Health Workers in Integrated Management of Malaria (IMM), Health Management Information Systems (HMIS) and Supervision for Private Sector Reporting In 15 Districts By 2023

2: Integrated Community Malaria Case Management (ICCM) at all Levels through partnership with the relevant District Leadership and other Malaria Actors in 15 Districts by 2023