There are more than 23.1 million people in Afghanistan living in areas at risk for malaria transmission, covering 78% of the population. Much progress has been made in controlling malaria in the last decade, with the total number of confirmed malaria cases decreasing from 16.8 per a population of 1,000 up to 1.6 per a population of 1,000. The World Malaria Report 2014 estimates the number of annual confirmed malaria cases in the country in 2013 at 39,263, reported deaths 24, with 95% P.vivax cases and 5% P.falciparum cases. Despite the decrease in malaria prevalence in Afghanistan in the past decade, it is important to continue and to further improve the malaria control activities, to sustain the gains reached thus far.
Success in distribution of bed nets
During the last two decades Health Works piloted, researched, introduced and distributed bed nets in different regions. The organization has been the main stay of malaria research and technical support to government and other implementing bodies including private sector in the Afghanistan and Pakistan.
Health Works started the distribution of bed nets in Afghanistan. In the past 10 years almost 10 million bed nets have been distributed. The distribution covered a wide geographic area, including 126 districts of 29 provinces out of 34 provinces. More than 20 million people now have access to bed nets.
Communities were directly involved in recruiting the community health workers, teachers and other literate people who could conduct a survey, register and distribute vouchers. Local NGO’s and community health workers go door to door and distribute vouchers based on the number of people living in a household. Each voucher can be returned for one bed net on the day of distribution. During receiving the bed nets, vouchers were collected in the presence of the elders of the communities where monitoring visits were carried out by government central and provincial authorities and Health Works central and provincial staff. These visits are carried out to supervise the distribution process, as the system is implemented by local NGO’s and community health workers. Health authorities are also included in this process to ensure openness of our activities and in order to include them in the implementation of the programme. Additionally TV spots and radio messages were broadcasted in Dari and Pashto language to make people aware of bed net distribution, usage in order in to prevent malaria.
Health Works has a long history performing operational research in its health programs and research findings have helped tremendously to improve its health programs. Research subjects included prevalence studies, antimalarial drugs studies, bed net studies, health facility studies, entomological studies and vector-control studies have helped to decrease malaria morbidity and mortality. These malaria control studies have led to nearly 50 publications in peer-reviewed journals (like the Lancet, the British Medical Journal, Social Science and Medicine and the JAMA) and many other study reports.
Key elements of the project:
a) Distribution of bed nets, along with training and awareness raising on the importance of bed net usage
b) Training of health workers in detection and first- line treatment of malaria
c) Research on the sustainability of bed nets and insecticide resistance
Activities and results include: