Malaria as an entry point for addressing other conditions
The Battle Plan Whilst malaria remains one of the leading causes of death and illness in children under five years, it is just one piece of the puzzle.
Whilst malaria remains one of the leading causes of death and illness in children under five years – with an estimated 437,000 deaths per year attributed to the disease – it is just one piece of the puzzle. When considering child health, we cannot look at malaria in complete isolation from other major illnesses. In 2013 alone, pneumonia accounted for over one in five under-five deaths, whilst diarrhoea made up over one in seven. In addition, malnutrition is an underlying contributor to all of these conditions, heightening the risk of infection and poor health. There are also similarities when it comes to assessing and treating illness; for example, pneumonia and malaria are both associated with fever which means they are often confused, leading to inappropriate and unnecessary treatments.
In our experience, one key strategy to improving health outcomes in young children lies in integration. Given the high degree of overlap in symptoms and location among the main childhood illnesses, Malaria Consortium has used its expertise in malaria as an entry point to address these other conditions in order to improve overall health of children under five in sub-Saharan Africa.
Our history with disease control began with malaria, but over time we began to see opportunities to expand our scope of work. In Ethiopia, Mozambique, Uganda and Zambia, our Irish Aid grant allowed us to explore health gaps and use our malaria expertise as a way to strengthen health systems by addressing weaknesses related to delivery of effective healthcare, particularly at district level. In Uganda, we also supported the National Malaria Control Programme to pioneer a Home Based Management of Fever strategy, which focused on training volunteers, known as community drug distributors, to treat children with malaria in their own communities. Then, when the World Health Organization and UNICEF endorsed the integrated community case management (iCCM) strategy – which trained community health workers to diagnose and treat a number of childhood illnesses – we adapted what had been developed for home-based management of fever, and began to advocate for large-scale adoption of iCCM, working to ensure that it became incorporated into national health systems. In South Sudan, this strategy included assessment and treatment of undernourished children who were provided with therapeutic foods.
The results of integrated healthcare have been encouraging. Not only have these initiatives brought services closer to home by training community health workers particularly in hard-to-reach areas, but they have also facilitated links between remote villages and health centres.
The benefits of integrated strategies are now being recognised more widely, so that organisations such as the Global Fund have started to incorporate support for integrated strategies into funding typically reserved for malaria. Now, we need to make sure that more and more reliable funding mechanisms are established for these initiatives so that they continue to produce better health outcomes and increase access to effective healthcare for vulnerable children.