Evaluation Of Malaria Prevention And Treatment Project

BackgroundMalaria, one of the most widespread and severe tropical diseases, threats the health and safety of the people and along with AIDS and tuberculosis, ranks the three major public health problem worldwide. World Health Organization issued Malaria elimination guideline in 2006 to encourage and eliminate Malaria in countries and regions where it is possible. Ambitious goal of eliminating Malaria deaths by 2015 and eradicating Malaria globally eventually was proposed in "Global Malaria Action Plan" by UN High-Level Meeting on MDGs in 2008.Malaria did serious harm to the health and safety of people as well as the social and economic development in our country. Since the foundation for People’s Republic of China, our prevention and treatment of malaria has made remarkable achievements after four major phases by implementing the policy of focus on prevention with scientific guide and the principle based on different local condition and classification. The 2006-2008 national Malaria morbidity statistics revealed that the incidence rate for three consecutive years in 97.38 percent of the counties (cities, districts) had dropped to lower than 1/million or no local infections, which indicates the prevention of malaria in our country transferred from controlling to eliminating. "Action Plan of China Malaria Elimination (2010-2020)" was published in May,2010 by our government, who decided to start the national Malaria elimination work from 2010 and aimed to the eliminate the local malaria cases in regions other than the border areas of Yunnan by 2015 and eradicate malaria national wide by 2020.As an important part and useful supplement to our national Malaria elimination action plan, our application for Global Found NSA of Malaria Project had been approved in 2009, which provided strong finical support and project management experience to archive our target on time and to eliminate Malaria in our country as well as in other countries.ObjectivesThis research aims to evaluate the Malaria Prevention and Treatment Project, analysis the trend of Malaria in our country so as to provide recommendations for future malaria control by gathering and analyzing the Global Fund NSA Project investments, activities, outputs, effects and other results.MethodsLiterature review. Summarize the current status of malaria prevention and treatment in our country and the development trend of malaria in the future by consulting the relevant literature of national and global malaria control effect evaluation, national Malaria control policy or technical documents and Malaria statistic.Collection and analysis of secondary data. Sort and analyze the information of the inputs, interventions and activities, results of Global Fund NSA malaria project.Analyze the success and inadequacy of the policy implementation and carry out reference for Malaria elimination in the future by applying the "results chain" logical framework to analysis the Global Fund NSA Malaria Project, researching the representative data of the project and comparing with the milestones and indicators in the "Action Plan of China Malaria Elimination (2010-2020)"ResultsThe effect of the prevention and treatment is significant. Since the implementation of the NSA Malaria Projects two years ago, the incidence of malaria has dropped to lower than 1/10000 in 88% of the first class counties (cities, districts) national wide.21% and 86% of the first and second class counties (cities, districts) reported no local infection. The incidence rate of falciparum malaria keeps decreasing in Yunnan and Hainan provinces, counting by county as a unit. No local infection of falciparum Malaria was reported in Hainan province and the falciparum malaria incidence rate was close to one hundred thousandth in Yunnan by Dec 31st,2011. The national Malaria epidemic reporting demonstrated a sharp decrease of national incidence rate of malaria and of the counties reported malaria cases as well as a great change for the national classification of malaria-endemic areas and the proportion of malaria types.The majority of the prevention and treatment target is accomplished. The "laboratory detected rate of malaria", ranks at 97.83%, achieved the expected goals and the "laboratory confirmed rate of malaria", which is 84.86%, exceeded expectation. There is a still gap between Standard treatment completion rate,85.69% and the target. And the Hugh root treatment completion rate which reaches 147.90%. on the other hand, far exceeded expectations. The proportion of "households having at least one long-lasting nets/ITN" is 88.29%, which is also above the target. However, there are also gaps between "epidemic disposal rate" and the proportion of "respondents slept in long-lasting nets/ITN the night before the survey" and their expectations, which need more effort. Health education publicity coverage reaches 98.09%(12509/12753). Both of the percentage of residents and schoolchildren who are aware of Malaria prevention and treatment knowledge increased obviously. The skill training for all level professionals also completed successfully.63.41% of the township medical and preventive care personnel and 98.02% of village doctors attended the training in the regions where the project is implemented.94.9% of them are quite satisfied or very satisfied with the project training.The project investments provide the anti-Malaria protection. The funds invested by the NSA project, hygiene products and other supplies greatly ease the insufficiency of resources to achieve the desired objectives in the regions where the project is implemented to eliminate malaria. The microscope, long-lasting mosquito nets, insecticide, rapid diagnostic test strips and other devices obtained by project procurement timely makes up the gaps in disease control institutions at all levels and township hospitals regarding the Malaria diagnosis and prevention. At the meanwhile, the issued transport, office equipment and other supplies provided the material support for the current and future carry out of Malaria prevention and treatment work in these regions. In addition of the technical training the NSA project offered to the professionals, various project management trainings were also provided to project members and financial officers to help them master the project management concept of Global Fund, explore the ideas and improve management skills. All these ensure project with more and more talents to keep project works orderly. Government mobilization and multi-division collaboration is another concern of the project. The smooth communications channels set up the mechanism guarantee for the Malaria elimination work.ConclusionOur national Malaria incidences numbers decreased significantly and the distribution of the incidences has also changed greatly, which means our Malaria elimination work has been to a new stage. Therefore, changing our Malaria control strategies response according to epidemic changes will play an important role in achieving the goal of eliminating Malaria. Imported cases of malaria have become one of the priorities of the current Malaria prevention and treatment work as the local Infections decreased. On the other hand, re-allocation of resources is also required by the re-division of the national malaria-endemic countiesSuggestions for Malaria prevention and treatment in the future are:Improve the quality of malaria control efforts by introducing the NSA Malaria project management methods. Continue the input and integrate the resource. Enhance the research of critical technology and focus elimination strategy transformation and technical innovation.