Zambia National Malaria Indicator Survey (MIS) 2010 Welcome!! The Barn Motel Lusaka

MIS 2010 You are here for training and participating in a national household survey to measure progress in malaria prevention and control services We will spend 1 week training and then will spend about 6 weeks carrying out the survey in all parts of Zambia

Why conduct a household survey?

National Malaria Strategic Plan A malaria ‘free’ Zambia Scaling up for impact –Focus on prevention during scale up –Improving diagnosis and care Effective program management Empowering individuals and communities Commitment to M&E

Priority malaria interventions Case management –with ACTs (Coartem©) as first line treatment and improvements in diagnostic services using microscopy and RDTs Prevention –Insecticide-treated mosquito nets, now exclusively LLINs –Indoor residual spraying (IRS) in 15 mainly urban districts, expanding to 22+ in 2008 –Prevention of malaria in pregnancy, including IPT(SP) and ITNs

Reminder: Targets and Goals National Strategic Plan a reduction of malaria incidence by 75% and deaths due to malaria will be significantly reduced by the end of 2011 a reduction of all cause mortality by 20% in children under five Abuja Targets 60%  80%  100% At least 80% of those suffering from malaria should be able to access and use correct, affordable and appropriate treatment within 24 hours of onset of symptoms. At least 80% (or 85%) of those at risk of malaria, particularly pregnant women and children under 5 years of age, should benefit from suitable personal and community protective measures such as ITNs. At least 80% of all pregnant women who are at risk of malaria, especially those in their first pregnancies should receive IPT

Background Zambia MIS 2010 objectives: –To collect up-to-date information on Coverage of Core interventions in NMSP ( ) to guide planning and implementation. –Assess malaria parasite prevalence according to the standardized RBM MERG recommendations; –Assess the status of anaemia among the target populations (children 6-36 months) according to the RBM MERG recommendations; –Strengthen the capacity of the NMCC and local agencies in implementation of malaria surveys.

Tools/Techniques Personal Digital Assistants (PDAs) –Household listing –Questionnaires Malaria parasite and anaemia testing –Hemocues –Rapid Diagnostic Tests (RDTs) –Malaria blood slides –Filter papers/blood spots

PDAs / GPS Two critical advantages –Time saving: 1) In one field visit, both the 2 nd stage household selection and interviewing conducted 2) combining multiple team member HH listings –Highly efficient at data processing One important disadvantage –If the programming is not correct, BIG potential source of error FYI: gadgetry, importation, available pool of PDAs, software development, lessons learned (Windows Mobile 5, VB vs. Visual CE)

Logistics Training: 24 March -31 March –Facilitated by NMCC, WHO, MACEPA, HSSP, UNZA, PMI, MTC Field work: 1 April- first week of May Survey teams included: –15 Field Teams (national sample) 2 nurses from surveyed districts (MoH), 2 lab techs/microscopists, CSO, 1 driver –~32 people involved in focused survey in Luangwa/Nyimba district created from select UNZA MPH students –Several participants for IVCC survey (Emanuel Chanda-NMCC, Mike Coleman, MRC Durban)

Research Ethics Approval University of Zambia Centre’s for Disease Control and Prevention for PMI PATH (for MACEPA) Consent for participation, finger sticks/testing and women’s questionnaire

Sensitization MoH, CSO, partners MoH Province Districts facilities CHW chiefs/headmen communities Community radio stations