CAMBODIA MALARIA ELIMINATION PROJECT (CMEP) Contract Number: AID-442-C-17-00001 REPORT ON THE RAPID SITUATIONAL ANALYSIS IN SELECTED ODS TARGETED FOR TRANSITIONAL MALARIA ELIMINATION July 5, 2017 Submitted by: University Research Co., LLC Phnom Penh, Cambodia USAID | PMI Cambodia Malaria Elimination Project - Situational Analysis 1 Contents Abbreviations ................................................................................................................................................ 4 Background ................................................................................................................................................... 7 Assessment Purpose: ..................................................................................................................................... 7 Field assessment and data collection ............................................................................................................ 8 Key Findings ................................................................................................................................................. 9 OD Battambang (BTB) ............................................................................................................................. 9 A. Current coverage gaps in malaria prevention and control activities ........................................... 14 B. Weaknesses in quality of diagnosis and treatment, vector control and surveillance .................. 15 C. Strengths and weaknesses in organizational structures, managerial processes, and provision of priority health activities. ..................................................................................................................... 16 D. Determine health provider capacity, service availability and quality, infrastructure needs, and health care provider skills for delivery of malaria services ................................................................ 18 E. Identify gaps ................................................................................................................................ 19 F. Summary ..................................................................................................................................... 20 OD Thmor Kaul (TMK) .......................................................................................................................... 22 A. Current coverage gaps in malaria prevention and control........................................................... 26 B. Weaknesses in quality of diagnosis and treatment, vector control and surveillance .................. 27 C. Strengths and weaknesses in organizational structures, managerial processes, and provision of priority health activities. ..................................................................................................................... 28 D. Determine health provider capacity, service availability and quality, infrastructure needs, and health care provider skills for delivery of malaria services ................................................................ 29 E. Identify gaps ................................................................................................................................ 29 F. Summary ..................................................................................................................................... 30 OD Moung Ressey (MRS) ...................................................................................................................... 32 A. Current coverage gaps in malaria prevention and control........................................................... 36 B. Weaknesses in quality of diagnosis and treatment, vector control and surveillance .................. 37 C. Strengths and weaknesses in organizational structures, managerial processes, and provision of priority health activities. ..................................................................................................................... 37 USAID | PMI Cambodia Malaria Elimination Project - Situational Analysis 2 D. Determine health provider capacity, service availability and quality, infrastructure needs, and health care provider skills for delivery of malaria services ................................................................ 38 E. Identify gaps ................................................................................................................................ 39 F. Summary ..................................................................................................................................... 40 OD Kra Kor (KRK) ................................................................................................................................ 42 A. Current coverage gaps in malaria prevention and control........................................................... 46 B. Weaknesses in quality of diagnosis and treatment, vector control and surveillance .................. 47 C. Strengths and weaknesses in organizational structures, managerial processes, and provision of priority health activities ...................................................................................................................... 47 D. Determine health provider capacity, service availability and quality, infrastructure needs, and health care provider skills for delivery of malaria services. ............................................................... 48 E. Identify gaps ................................................................................................................................ 50 F. Summary ..................................................................................................................................... 51 OD Phnom Kravanh (KRV) .................................................................................................................... 53 A. Current coverage gaps in malaria intervention and control: ....................................................... 56 B. Weaknesses in quality of diagnostic and treatment, vector control and surveillance: ................ 58 C. Strengths and weaknesses in organizational structures, managerial processes, and provision of priority health activities ...................................................................................................................... 58 D. Determine health provider capacity, service availability and quality, infrastructure needs, and health care provider skills for delivery of malaria services ................................................................ 60 E. Identify gaps ................................................................................................................................ 61 F. Summary ..................................................................................................................................... 62 Discussion ................................................................................................................................................... 63 USAID | PMI Cambodia Malaria Elimination Project - Situational Analysis 3 Abbreviations ACT Artemisinin-based Combination Therapy AFD Agence Francaise De Development AOP Annual Operational Plan BTB Battambang CAP-Malaria Control and Prevention of Malaria CMEP Cambodia Malaria Elimination Project CMS Central Medical Store CNM National Center for Parasitology, Entomology and Malaria Control CRS Catholic Relief Services DFID Department for International Development EDAT Early Diagnosis and Treatment FDH Former District Hospital GF Global Fund HEF Health Equity Fund HC Health Center HF Health Facility HP Health Post HMIS Health Management Information System HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome IPD In-Patient Department IPC Interpersonal Communication KOFIH/KOICA Korea International Cooperation Agency KRK Krakor LLIN / LLIHN Long Lasting Insecticidal Net / Hammock Net USAID | PMI Cambodia Malaria Elimination Project - Situational Analysis 4 M&E Monitoring and Evaluation MCH Maternal and Child Health MIS Malaria Information System MMP Mobile and Migrant Population MMW Mobile Malaria Worker MPA Minimum Package of Activity MRS Maung Russey NGO Non-Government Organization NTG National Treatment Guideline OD / ODMS Operational Health District / OD Malaria Supervisor OPD Out Patient Department PHD Provincial Health Department PKV Phnom Kravan Pf Plasmodium falciparum PH Provincial Hospital PMI President’s Malaria Initiative POC Point of Care PP Private Provider PPM Private Public Mix PQ Primaquine PSK Population Services Khmer Pv Plasmodium vivax QC Quality Control QI Quality Improvement RDT Rapid Diagnostic Test RDQA Routine Data Quality Assessment RH Referral Hospital USAID | PMI Cambodia Malaria Elimination Project - Situational Analysis 5 RRT Rapid Response Team SOP Standard Operating Procedure SPL Sampov Loun TB Tuberculosis TMK Thmar Kaul TOT Training of Trainer UNICEF United Nations Children’s Fund URC University Research Co. USAID United States Agency for International Development USD United States Dollar VHSG Village Health Support Group VMW Village Malaria Worker WHO World Health Organization USAID | PMI Cambodia Malaria Elimination Project - Situational Analysis 6 Background The USAID | PMI Cambodia Malaria Elimination Project (CMEP) will support the Cambodian National Center for Malaria Control, Parasitology and Entomology (CNM) to reduce malaria morbidity and mortality and eliminate malaria nationwide by 2025. The project will work