Sierra Leone – Home management of malaria with Artemisin Combination Therapy reduces child mortality

BACKGROUND - Malaria is the leading cause of morbidity and mortality among under-five children in Sierra Leone. PROGRAM – Plan International, a child-centered community development organization, in partnership with the government and with funding from the Global Fund, is implementing a five-year project to combat malaria. A key project intervention is the Home Management of Malaria using Artemisinin Combination Therapy (HMM/ACT). While ACT drugs are available in most public health facilities, their utilization at the community level is as low as 10% of suspected cases. Possible reasons for this low community use are inability of pregnant women and their children to access these new drugs within 24 hours due to long travel time and little/no knowledge about these drugs and their free distribution at health facilities and communities. In response, Plan and the Ministry of Health identified and trained volunteer community-based providers (CBPs) on the HMM/ACT. The project also implemented community education and radio programming to announce the beginning of HMM/ACT. RESULTS - 724 CBPs were trained in four districts to cover 3,620 communities with HMM/ACT. The number of malaria cases treated by CBPs has increased by four times, while malaria mortality has decreased by the same range and in the same geographical areas. Less severe cases are seen by CBPs and front-line health workers. For example, convulsion rates have significantly reduced among under-five children. CONCLUSION – HMM/ACT by CBP decrease severity and mortality due to malaria. With funding from the Global Fund, the government is beginning its nationwide implementation.