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Assessment of the Zimbabwe Assistance Program in Malaria April 2020

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Assessment of the Zimbabwe Assistance Program in Malaria April 2020 Assessment of the Zimbabwe Assistance Program in Malaria April 2020 Assessment of the Zimbabwe Assistance Program in Malaria April 2020 This publication was produced with the support of the United States Agency for International Development (USAID) under the terms of the Data for Impact Data for Impact (D4I) associate award University of North Carolina at Chapel Hill 7200AA18LA00008, which is implemented by 123 West Franklin Street, Suite 330 the Carolina Population Center at the Chapel Hill, NC 27516 USA University of North Carolina at Chapel Hill, in Phone: 919-445-9350 | Fax: 919-445-9353 [email protected] partnership with Palladium International, LLC; http://www.data4impactproject.org ICF Macro, Inc.; John Snow, Inc.; and Tulane University. The views expressed in this publication do not necessarily reflect the views of USAID or the United States government. TRE-20-29 D4I ISBN 978-1-64232 -258 -3 Assessment of the Zimbabwe Assistance Program in Malaria 2 Acknowledgments This assessment was undertaken by Data for Impact (D4I), funded by the United States Agency for International Development (USAID), in collaboration with the Zimbabwe National Malaria Control Program (NMCP) and the U.S. President’s Malaria Initiative (PMI)/Zimbabwe. The following people were involved in the assessment: Agneta Mbithi, Yazoumé Yé, Andrew Andrada, Cristina de la Torre, Logan Stuck, Joshua Yukich, Erin Luben, and Jessica Fehringer (D4I); and Brian Maguranyanga and Jaqueline Kabongo (M-Consulting Group). The assessment team thanks the people who generously shared their time, experiences, and ideas for the assessment, including the NMCP, led by its director, Dr. Joseph Mberikunashe; the provincial, district, and facility teams; the Zimbabwe Assistance Program in Malaria team; malaria implementing partners (IPs); and the outpatient and antenatal care patients at the health facilities visited. Thanks to the malaria stakeholders for providing feedback during the consultative dissemination meeting held in Harare on November 13, 2019. The assessment team also thanks the PMI Zimbabwe team for its guidance and support during the assessment: Christie Billingsley, Peter Troell, and Regis Magauzi. Special thanks to Cindy Young-Turner of ICF for editing and proofreading of this document, and to D4I’s University of North Carolina-based knowledge management team for editorial, design, and production services. The assessment was funded by PMI Zimbabwe. Cover photo: Courtesy of Zimbabwe Assistance Program in Malaria Suggested citation: Data for Impact (D4I). (2020). Assessment of the Zimbabwe Assistance Program in Malaria. Chapel Hill, NC, USA: D4I, University of North Carolina. 1 Assessment of the Zimbabwe Assistance Program in Malaria Contents Acknowledgments ..........................................................................................................................1 Contents .....................................................................................................................................2 Figures ........................................................................................................................................4 Abbreviations ................................................................................................................................6 Abstract ......................................................................................................................................8 Executive Summary ........................................................................................................................9 Background ................................................................................................................................ 13 Country Profile ........................................................................................................................ 13 Overview of PMI in Zimbabwe .................................................................................................... 15 Overview of ZAPIM .................................................................................................................. 15 Assessment Methods ..................................................................................................................... 21 Intent of the Assessment ............................................................................................................. 21 Framework ............................................................................................................................. 21 Assessment Design .................................................................................................................... 22 Assessment Approach ................................................................................................................ 22 Data Management and Analysis ..................................................................................................... 24 Ethical Considerations ............................................................................................................... 25 Results ...................................................................................................................................... 26 Description of the Sample ........................................................................................................... 26 Trends for Malaria Program Indicators ........................................................................................... 27 Burden of Malaria ..................................................................................................................... 33 Regression Model ..................................................................................................................... 36 Quality of Malaria Care .............................................................................................................. 38 Implementation Capacity of PHMTs and DHMTs .............................................................................. 43 Facilitators and Barriers to Implementation ......................................................................................... 45 Facilitators of Achievements ........................................................................................................ 45 Barriers to Achievements ............................................................................................................ 48 Synthesis of Key Findings ............................................................................................................... 54 Malaria Program Indicators ......................................................................................................... 54 Effects of LLIN CD and CM ........................................................................................................ 54 Assessment of the Zimbabwe Assistance Program in Malaria 2 Quality of Care ........................................................................................................................ 54 Implementation Capacity ............................................................................................................ 54 Facilitators and Barriers .............................................................................................................. 54 Gender .................................................................................................................................. 55 Limitations and Challenges in the Assessment ...................................................................................... 56 Recommendations ........................................................................................................................ 57 Appendix A. Document Review ....................................................................................................... 59 Appendix B. ZAPIM Assessment Consent Forms and Questionnaires ......................................................... 61 Appendix C. List of Facilities Visited ................................................................................................. 98 Appendix D. Conflict of Interest Forms ........................................................................................... 101 Appendix E. Protocol .................................................................................................................. 105 Appendix F. Staff Biographies ........................................................................................................ 125 3 Assessment of the Zimbabwe Assistance Program in Malaria Figures Figure 1. ZAPIM targeted provinces and districts (areas outlined in blue are ZAPIM districts) ........................... 16 Figure 2. ZAPIM assessment framework ............................................................................................. 21 Figure 3. Impact model ................................................................................................................. 22 Figure 4. LLIN CD, 2013–2018 ....................................................................................................... 28 Figure 5. Continuous LLIN distribution in schools, 2016 ........................................................................ 29 Figure 6. LLIN mass distribution, 2013–2018* .................................................................................... 30 Figure 7. IRS coverage, 2013–2018* ................................................................................................
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