Progress and challenges towards eliminating malaria in afghanistan

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  • WHO MEETING ON PROGRESS ACHIEVED WITH MALARIA ELIMINATION IN THE WHO EUROPEAN REGION , ASHGABAT, TURKMENISTAN, 30 OCTOBER – 1 NOVEMBER 2007
  • WHO MEETING ON PROGRESS ACHIEVED WITH MALARIA ELIMINATION IN THE WHO EUROPEAN REGION , ASHGABAT, TURKMENISTAN, 30 OCTOBER – 1 NOVEMBER 2007
  • Progress and challenges towards eliminating malaria in afghanistan

    1. 1. Progress and challengestowards eliminating malaria in Afghanistan Najibullah Safi, MD, MSc. HMP, DMPPM National Malaria and Leishmaniasis Control Program Manager MoPH - Afghanistan
    2. 2. Malaria Transmission in AfghanistanWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 2
    3. 3. Anti Malarial Treatment in Health Care System of Afghanistan  Health post (HP) Clinical Malaria  Basic health center (BHC)  Comprehensive health center  District hospital Confirmed Malaria  Provincial hospital  Specialized hospitalWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 3
    4. 4. Achievements  Health care system cover 82% of the population  Formulation of policies and guidelines – National strategic plan – National treatment protocol (adopting ACT for confirmed PF) – Epidemic preparedness and response – Malaria microscopy for lab technicians – Diagnosis and treatment of sever complicated malaria – Treatment guideline for community health workers – National IVM strategic plan – Addition of malaria into school curriculumWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 4
    5. 5. Achievements cont.  Establishment of 14 quality assurance centers  Improvement in reporting system – 980 health facility report malaria cases – 8000 health posts (16000 CHWs) – Piloting the Global Malaria Database  Training – Public (including BPHS implementing NGOs) – Private (lab technicians, MDs, pharmacist…)WHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 5
    6. 6. Achievements cont.  GFATM (R5) approved 2.1 million LLINs over 5 years  In current year more than 300,000 LLINs distributed in target provinces  Construction of new building for headquarter of the program and research and training instituteWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 6
    7. 7. Achievements cont.  Vector surveillance – Entomology unit established in NMLCP • Plan to establish three Vector Control units in provinces  Regular monitoring of anti-malarial drugs since 2003 – Results up-to-date show 100% ACPRWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 7
    8. 8. Achievements cont. Trend of Malaria 2002 – 2006 700000 600000 Number of Reported Cases 500000 400000 300000 200000 100000 0 2002 2003 2004 2005 2006 Years Malaria reported casesWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 8
    9. 9. Challenges  Insecurity  Scarcity of resources – Financial – Human  Lack of motivation  Fragmented health care system  Poor coordination among stakeholders  Gratuitous interference  Time-consuming bureaucratic channelsWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 9
    10. 10. Challenges cont.  Geographical, economical and cultural barriers affecting easy access to facilities with laboratory services (CHC and DH)  Absence of lab facility in HP and BHC – On average 1.5 lab/district exist to provide a multitude of tests including malaria  Reduction in proportion of confirmed cases over the yearsWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 10
    11. 11. Challenges cont. 70 61.6% of confirmed cases 60 50 40 30 19.4 20 10 0 2003 2006 Year Proportion of confirmed cases WHO meeting on progress achieved with malaria elimination in the WHO European region Ashgabat, Turkmenistan, 30 October – 1 November 2007 11
    12. 12. Challenges cont.  Unregulated private sector  Wide practice of self medication  Sustainability of the programWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 12
    13. 13. Prospects  Future of malaria control is promising – Financial support from GF (Round 5) • Plan to apply for the next round of GF – Political commitment – Enhanced technical support and better cooperation with WHO – Piloting RDT in three WHO CBI/BDN projects – Upcoming cross border project with TajikistanWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 13
    14. 14. Prospects cont. – Establishment of new health facilities (sub- centers) under GAVI fund for strengthening health care system – Establishment of 18 sentinel sites to monitor the trend of malaria in high risk provinces – Establishment of malaria advisory board (enhanced coordination) – Incentives for the staff from GF – Changes in program leadershipWHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 14
    15. 15. WHO meeting on progress achieved with malaria elimination in the WHO European regionAshgabat, Turkmenistan, 30 October – 1 November 2007 15

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