Health & HIV/AIDS
Africare Technical Capacity:
Over the years, Africare has successfully implemented numerous malaria control programs throughout Africa. The countries where the programs have been or are currently in operation include: Angola, Benin, Liberia, Nigeria, Senegal, Tanzania, Uganda and Zambia.
As with the goal of President George W. Bush’s President’s Malaria Initiative (PMI), our programs aim to reduce morbidity and mortality caused by malaria. The percentage we aim to reach varies by country; and our target groups (similar to that of PMI) are children under five years of age and pregnant women; two populations who are most threatened by malaria.
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Africare has expertise in three of the four proven and highly effective malaria prevention and treatment measures: (1) Long Lasting Insecticide Treated mosquito Nets (LLITN); (2) Intermittent Preventive Treatment for pregnant women (IPTp) and; (3) Artemisinin-based Combination Therapy (ACT) for the treatment of children under the age of five.
Africare has not participated in the fourth and once controversial malaria prevention intervention—indoor residual spraying.
Africare has also set up simple, but effective monitoring and evaluation systems (M&E) systems that can be easily integrated into national malaria control programs to monitor morbidity and mortality. As well, Africare has scaled up LLITN, IPTp and ACT distribution in areas with weak pharmaceutical management and health care systems.
Overall - and more importantly - Africare’s work over the life of our projects are designed to contribute to improved political environments; increased access to improved services; strengthened service management and health system capacity; and increased demand and use of services and preventive measures.
Africare’s strategies expand, develop, and improve our programs and include the Service Corps Volunteers (SCV) model, which improves communities through the use of local volunteers. Our work also utilizes capacity building, needs assessments, partnerships, technical assistance, monitoring and evaluation, and small grants to local organizations to carry out our work in African communities.
Africare works with community structures (e.g. community health workers, grandmother groups, traditional birth attendants (TBA), traditional healers, Faith-based Organizations (FBO), Community-based Organizations (CBO) and the local private sector, e.g. patent medicine vendors, etc.) to promote awareness of and increase access to LLITN. By working with community structures, we have been able to expand and deliver the LLITN inside and outside of formal health systems, which are sometimes either weak or inaccessible to many communities.
Africare also conducts training on how to use and properly care for bed nets, and teaches the importance of the nets for malaria prevention. Our target group includes community distributors and service delivery points (e.g. health care workers, Antenatal Clinic (ANC) staff, TBAs, and all community groups) in the delivery of health care services to pregnant women and children. To further increase access to nets, we train community leaders to promote the use of nets and distribute them to pregnant women and children under five, via community events such as local village meetings and community campaigns.
Information, Education and Communication (IEC) materials are distributed by various community structures during house-to-house visits, women’s group meetings, and church activities (mothers’ union meeting, mother’s day celebration, etc.) to name a few. Theses materials are used to create demand and educate about malaria prevention.
To increase affordability, availability and demand for LLITN, Africare has initiated bed net revolving funds, in order to distribute subsidized and cost-recovery of the nets. This model allows community members to purchase LLITN at a wholesale price, which is at least 25 percent less than the retail price. Through this mechanism, we have supported, strengthened and contributed to the distribution of several thousands of highly subsidized nets, and have increased the number of people that not only own, but also sleep under the enhanced nets. Additionally, Africare uses a market segregation/ sliding scale approach to the distribution of LLITN, whereby the poorest and most vulnerable (pregnant women and children under five) are provided with free LLITN. This is done using bed net vouchers given to them at local health facilities.
Africare’s strategy for implementing health programs is to link rural, remote communities with private and public health care systems. Some projects support public health by developing referral systems that connect communities with public health facilities, while others focus on health promotion through behavior change communication (BCC) approaches, and community-based distribution of essential drugs and contraceptives.
Approaches that are shared by all of Africare’s current health programs include a BCC emphasis using both traditional and modern media, and use of improved Health Information Systems management (HIS) for policy and operational decision making, and partnership reinforcement. In many countries, Africare’s community-based approach to health care has played a considerable role in strengthening national systems in drug management, implementation of integrated management of childhood illnesses (IMCI), and building capacity among local NGO networks and community health workers.