Senegal: A successful community-based strategy for malaria control

In Senegal, malaria constitutes the primary reason for consultation in health facilities and represents the largest cause of morbidity (32.5%) among children under five years and pregnant women.

Plan Senegal, as part of a consortium of international non-governmental organizations funded by USAID, has managed a community health project since 2006. It includes two parts: an integrated package of community-based maternal, neonatal, and child health and family planning interventions and a community-level component of the Presidential Malaria Initiative (PMI). Thus, the fight against malaria, implemented in the 11 regions of Senegal and 59 health districts with a population coverage estimated at 4,014,829 inhabitants including children 0-5 years (778,877) and pregnant women (33,243), aims at reducing by 50% malaria-related morbidity and mortality.

The community actors underwent a standardized training with the same modules (trainer's guide, community health agent/matron guide, relay manual written by the consortium). The fight against malaria relies on seven principle strategies: early diagnosis and treatment of cases, protection of pregnant women, mobilization of community members for the fight against malaria (through innovative strategies such as the grandmother strategy; the circle of solidarity of pregnant women; the school strategy; information, education, communication groups; etc.), testing and early referral of cases, utilization of insecticide-treated bednets, hygiene and sanitation, and household spraying.

The district of Nioro (50,000 pop) is supported by Plan Senegal and all the malaria control strategies were put into place. During the April-June 2008 quarter, 98% of malaria cases were treated according to the norms; though the objective was to reach 6,000 people, close to 20,000 individuals were reached by an activity and/or by malaria prevention. In June 2008, the coverage of free distribution of long-lasting, insecticide-treated bednets was 98%. During the second round of household spraying in this test district, the rate of buildings treated in the concessions was 95%.

The Government of Senegal, in agreement with its development partners, is in the process of studying the possibility of extending this community-based and integrated strategy to all the districts of the country.