Implementing Local Community-Based Malaria Control: Implications for Scaling-Up

Purpose: This abstract presents the results from a qualitative evaluation of a community-based malaria control program in southeastern Senegal and examines their implications for scaling up. Background: In 2009, the Senegalese National Malaria Control Program initiated Home-based Malaria Management (HMM), in which community health workers (CHWs) were trained to diagnose P. falciparum with rapid diagnostic tests and to treat patients with artemisinin-based combination therapy (artesunate + amodiaquine) (ACT). Methods: The training was evaluated through participant observation during the training and through site visits to CHW health huts 3 and 4 months after the training. Results: The training relied heavily on written materials even though six CHWs were unable to read or write. Additionally, during site visits after the training it was observed that the majority of the CHW health huts had not had either rapid test kits or ACTs for several months and the District Health Center was not able to provide them with more as it did not have adequate supplies to meet its own needs. Recommendations: The results suggest that more training materials should be developed for CHWs with low literacy. Further, adequate planning must be carried out prior to initiating HMM programs in order to avoid the widespread interruptions in the supply of tests and medications that were observed in Saraya. This research suggests that ensuring the adequate training of CHWs and the subsequent supply management of tests and drugs poses a central challenge in implementing a successful HMM program.