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PMI Impact Malaria's 2020 Year in Review

PMI Impact Malaria (IM) is the flagship global service delivery project of the U.S. President's Malaria Initiative (PMI), providing global technical leadership to fight malaria and save lives. IM supports countries in their efforts to strengthen malaria diagnosis, treatment, and drug-based prevention in health facility and community settings through implementation and technical support, as well as operational research.

In the project’s third year, IM operated in 18 countries across Africa and Asia and supported USAID’s Bureaus for Latin America and the Caribbean (LAC) and Africa.

Using IM’s comprehensive and standardized quality assurance approach, called Outreach Training and Supportive Supervision Plus (OTSS+), IM made major strides in accelerating quality improvement of country-driven malaria services in health facilities. Through developing a digitized global package of OTSS+ checklists, IM enabled 10 countries to conduct facility-level supportive supervision of health worker competency in three main areas: 1) managing uncomplicated and severe malaria, 2) preventing and treating malaria in pregnancy (MIP), and 3) performing malaria rapid diagnostic tests and malaria microscopy.

The OTSS+ digital data entry platform allowed for real-time feedback and troubleshooting, along with prompt development of quality improvement action plans. Using these OTSS+ data, IM performed detailed cross-country analyses to gain a clearer picture of the gaps in health worker performance and health facility readiness for high-quality malaria service delivery. IM is working closely with all 10 countries to address the gaps identified.

A microscopist in Niger prepares slides for malaria microscopic examination. Credit: PMI Impact Malaria

In 2020, IM countries were successful in moving forward most planned activities despite the COVID-19 pandemic. This is a snapshot of country-driven achievements that IM supported during the past year:

  • Prevented childhood malaria through implementation of seasonal malaria chemoprevention (SMC) campaigns in Cameroon, Mali, and Niger that administered antimalarial medicine to more than four million children during each of the four campaign cycles, while incorporating adaptations to protect children, families, and health workers from COVID-19 transmission. The success of the campaigns built on lessons learned from the 2019 campaigns.
  • Trained a total of 3,473 health workers across 10 countries in appropriate management of uncomplicated and severe malaria and prevention and treatment of MIP using updated guidelines and curricula that align with global policies and best practices.
  • Updated policies and training for integrated community case management (iCCM) in five countries – Cameroon, Côte d’Ivoire, Mali, Niger, and Rwanda – and then trained 2,697 community health workers using the updated iCCM curriculum. By the end of the year, 40% to 100% of children living beyond five kilometers of health facilities in IM-supported areas of those five countries had access to iCCM services in their community.
  • Conducted malaria diagnostic refresher trainings to improve skills among microscopists in the Democratic Republic of Congo (DRC), Ghana, Madagascar, Mali, and Zambia. Most trainees achieved a score of at least 80% in parasite detection, meeting the minimum standard competency score recommended by the World Health Organization (WHO) for malaria microscopy.
  • Introduced the OTSS+ standardized MIP module in Cameroon, Côte d’Ivoire, Mali, Niger, Rwanda, Sierra Leone, and Zambia. Overall, coverage of intermittent preventive treatment (IPTp) doses one to three in IM project areas was above the regional average.
  • Established and carried out an in-depth onboarding system to set up countries to use IM’s Data Hub, the project monitoring system. By the end of the year, seven countries – Cameroon, DRC, Ghana, Kenya, Mali, Rwanda, and Sierra Leone – were reporting their data into the Data Hub.
  • Published a methods and frameworks guidance tool in partnership with Breakthrough ACTION. The tool provides steps for using insights into health provider behavior to improve the quality of malaria service delivery. IM co-hosted a PMI-moderated webinar to help people understand the tool and encourage its uptake.
  • Created and disseminated digital and multimedia products for World Malaria Day 2020 to enhance awareness of PMI’s impact in protecting pregnant women from malaria, including a short advocacy video and a feature article on USAID’s Medium channel.

A mother and her baby at the Akwamufie Health Center in Ghana. Credit: Emmanuel Attramah, PMI Impact Malaria Ghana

IM’s COVID-19 Response

Under IM’s expanded mandate to include pandemic and epidemic response, IM developed and rolled out rapid COVID-19 guidance and training to health workers and laboratory technicians in Cameroon, DRC, and Ghana, which included providing essential hygiene supplies, generating critical data to inform response decisions, and training health workers on appropriate precautions for the pandemic context.

Altogether, the three countries trained 1,702 health workers. IM also modified current OTSS+ checklists to strengthen assessment of competencies in infection prevention and control and clinical and laboratory diagnosis of COVID-19. Lastly, IM developed six e-learning modules for health workers, in both English and French, that will enable countries to further expand training in COVID-19 infection prevention and control, and biosafety.

Read IM's latest blog posts to learn more about the human impact of IM’s country-driven work.

Header Photo Caption: Community health worker Jean Ngouoli explains antimalarial medication doses to Boussota, mother of two-year-old Sidonie, in Mouda, Cameroon during the fourth cycle of Cameroon's 2020 seasonal malaria chemoprevention (SMC) campaign. Credit: PMI Impact Malaria.

PMI Impact Malaria is led by Population Services International (PSI) in partnership with JhpiegoMedical Care Development International (MCDI), and the Malaria Elimination Initiative (MEI) at UC San Francisco.

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