FIFTH INTERCOUNTRY MEETING OF NATIONAL MALARIA PROGRAMME MANAGERS

1
Progress of RBM Implementation in Somalia

• WHO Somalis in collaboration with Local
  Authorities, UN Agencies, IntNGOs Local NGOs
  strengthened malaria control programe in all
  zones, in reducing morbidity and mortality.
• Human Resource capacity Building
• Training on Malaria Microscopy
• Training on Use and Re-treatment of ITNs
• Training on Case management for health
  Professionals
• Training on vector control measures
• Training on AMD efficacy study for Gedo Region
  Team (SZ)
• AMD efficacy studies carried out for AQ, SP and
  ASSP
• Introduction of IPTp in some ANCs in Central
  Zone
• Malaria surveillance system integrated with HIS
• Distribution of ITNs to target group through
  partners
• Indoor residual spray operation in epidemic
  prone areas in NWZ
• Africa Malaria Day commemorated in all Zones

2
Updates on Malaria Burden
3
Updates on Malaria Burden
4
Vector Assessment
5
Vector Assessment
6
Rainfall Assessment
7
Updates on case management - drug efficacy
studies , drug policy

• Drug policy in 2004
• First Line Chloroquine
• Second line S/P
• Third Line Quinine (Severe Malaria
  cases, Pregnancy)
• Interim Drug Policy in 2005
• First Line ASSP (HospitalsMCHs
  with Microscopy/RDTs)
• Second Line Quinine (Severe malaria
  Cases Pregnancy)
• Third line Coartem
• At Health Post level SP

8
Table 1 Therapuetic efficacy of Sulphadoxine /
Pyrimethamine (SP) in 2004
Data under analysis
9
Table 2 Therapuetic efficacy of Amodiaquine 2004
10
Table 3 Therapuetic efficacy of ArtesunateSP
2004-05
Data under analysis
11
Updates on case Management- diagnosis
12
Updates on vector control interventions and
inter-sectoral coordination for vector control at
country level

• ITNs
• 6700 ITNs distributed to all zones to target
  group.
• Re-treatment of ITNs in C Z (4000 nets)
• IRS
• 5 epidemic prone villages in NWZ were sprayed
  with IRS.
• Biological control
• Larvivorous fish distributed in NWZ
• Community sensitization through mass media and
  advocacy on malaria/vector control measures

13
Epidemics control

• Epidemics occurred in 2004 in CS Zone not
  responded due to insecurity.
• Larvivorous fish distribution in epidemic prone
  areas in NWZ.
• Epidemic preparedness plan in Place in NWZ and
  will be extended to other zones with support of
  EMRO in 2005

14
Updates on strengthening malaria ME and
surveillance system

• CDC surveillance and malaria Surveillance
  integrated
• ME has to be strengthen by training of Focal
  points
• 47 Surveillance sites reporting malaria data
• Epidemic sentinel sites for surveillance selected
  in NWZ and extended to other zones, staff
  training is required
• Malario-meteric survey completed in NWZ and CS
  zones. The data analysis will be ready by June
  2005
• NEZ MMHH survey will be conducted in July 2005

15
Partnership, resource mobilization and advocacy

• What has been done in 2004 related to the above
• GFATM Fund received from GF for malaria control
  project. In partnership with UNICEF and INGOs
• Prepared MOU with SRCS, ICD, INTERSOS to work for
  establishing and strengthening malaria microscopy
  in MCHs
• IDB No
• ECHO No
• Bilateral No
• Others No

16
Review of the progress on the malaria border
coordination

• Since 1999 several cross border meetings were
  held to develop border malaria control policy
• In 2002 meeting and technical training were held
  in Harar (Ethiopia)
• In 2003 Cross border malaria Microscopy training
  was
• held in Hargeisa for strengthening border
  MCHs for malaria microscopy ( 2 MCHs)
• Revive the malaria border coordination b/w
  Ethiopia,Djibouti and Somalia in 2005

17
Human Resource Development

• Main key activities Achievements
• Malaria Micro-scopists/Lab technicians
• NWZ NEZ CS Zone
  
• 10 25 21
  (8 Private Tech in NEZ)
• Case management
• 10 Health professional trained in Case
  management
• Vector Control Measures.
• 7 Entomology technician and Entomology
  .assistant trained in NWZ , C S zones
• Anti malarial drug efficacy study
• 3 teams were given refresher course and
  one New sentinel site team trained in Gedo region
  of South zone

18
Operational research

• Malaria-microscopy with RDTs in selected sentinel
  sites
• Larvivorous fish as a pilot project with control
• Insecticide treated sheet (Indoor) pilot study
  in Hut houses .

19
Conclusion

• Achievements.
• Human Resource development
• Extension of sentinel sites for Malaria
  Microscopy
• Extension of Anti Malaria Drug efficacy sentinel
  site
• Develop minimum vector control capacity in
  epidemic prone areas
• Epidemic response team available with limited
  resources
• Malario-meteric survey completed in three zones
• Vector behaviour pilot study conducted with EMRO
  consultant
• Drugs, reagents and equipments were provided to
  partners

20
Conclusion -cont

• Challenges
• Difficult to coordinate malaria control programe
  due to lack of Central Govt.
• Lack of drug Policy and drug regulation
• Irrational use of Anti-malarial (Self Medication)
• In-adequate laboratory facilities for malaria
  diagnosis
• Malaria Microscopy quality control mechanism is
  weak
• Lack if sustainability of trained staff (Brain
  Drain)
• Insecurity in certain areas

21
Conclusion - contd

• Way Forward
• Change of drug policy for Somalia (must consider,
  affordability and accessibility.)
• Better coordination between all Stakeholders and
  partners
• Strengthening and developing epidemic
  preparedness plan. Training by EMRO
  Consultant
• Strengthening and develop efficient quality
  control/quality assurance network for malaria
  microscopy/RDTs
• Develop effective M E system for malaria control
  

22
Africa malaria day in Jowhar

• Thank you for your Patience