SUCCESS STORIES

TANZANIA: Education Key to Zanzibar's Succesful Fight

PROBLEM:

Malaria is the number-one health problem in Zanzibar, two islands off the coast of Tanzania in East Africa. Zanzibar health facilities reported more than 400,000 cases of malaria in 2004, even though its population is only 1 million. Children under the age of five are most vulnerable to malaria and 80,000 of them die from malaria each year in Tanzania. In addition to lacking access to new malaria control technology (such as Long Lasting Insecticide-Treated Nets or LLINs), many families were unaware of LLINs or how to use them effectively.

SOLUTIONS:

With support from the U.S. President's Malaria Initiative (PMI) and the Global Fund for AIDS, Tuberculosis and Malaria (GFATM), Zanzibar launched a multi-faceted campaign that included:

333,000 LLINs distributed to pregnant woman and children under five. Another 180,000 re-treatment kits distributed.
Educational support to ensure proper usage and acceptance. Ten non-governmental organizations went house to house to reach 88% of households on the islands and three faith-based organizations disseminated malaria prevention and treatment messages through mosques and other activities. Radio and television spots promoted net installation and use, and aired on national media, including Radio Zanzibar and Television Zanzibar.
Indoor residual spraying (IRS) with ICON (lambdacyhalothrin) in July and September 2006, prior to the island's rainy season. Thanks to the educational campaign, the program encountered few refusals, with 93% of households accepting spraying in their homes. Prompt and effective case management of malaria with artemisinin-combination therapies which were introduced in 2003 with GFATM support and intermittent preventative treatment (IPT) for pregnant women.

LESSONS LEARNED:

Providing education as well as access to treatment and prevention improves malaria control. A survey conducted in mid-2006 after the LLIN distribution showed an 80% decline in confirmed cases. Malaria cases dropped again after the IRS campaign, more LLIN distribution, and community educational programs, with more positive results expected in January 2007 when another round of spraying will take place. In addition, an environmental cleanliness campaign to reduce standing water and breeding areas for mosquitoes combined with the other initiatives reduced the overall number of mosquitoes on the island. Combining ITN distribution, indoor residual spraying, prompt and effective case management of malaria, and intermittent preventative treatment (IPT) with the educational campaign and environmental clean up made for a balanced approach, combating malaria from several angles. Prompt disbursement of funds and a strong coordinating mechanism on the ground, informed by evidence-based decision-making facilitated the campaign's success.

Sources:

U.S. Agency for International Development (http://tanzania.usaid.gov/article.php?id=0088 EN)

"Tanzania shows sharp decline in malaria cases". ANDnetwork.com, August 27, 2006.

Contact for further details:

Abdullah Ali
Manager, Zanzibar Malaria Control Program
abdullahsuleimanali@yahoo.com

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