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Quarterly Progress Report July 1, 2019–September 30, 2019

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Program for the Advancement of Malaria Outcomes Quarterly Progress Report July 1, 2019–September 30, 2019 DISCLAIMER: The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development, United States President’s Malaria Initiative or the United States Government. Submission Date: October 31, 2019 Submitted by: Dr. Caroline Phiri, PAMO Chief of Party Mailing Address Private Bag E10, Lusaka, Zambia Street Address Mikwala House, Stand 11059 Off Brentwood Road, Longacres, Lusaka www.path.org © 2019 PATH. All rights reserved. Cover photo: PATH October 2019 1 TABLE OF CONTENTS LIST OF ACRONYMS 4 PROJECT OVERVIEW 6 INTRODUCTION 7 BENCHMARKS AND ACHIEVEMENTS 7 OBJECTIVE 1: SUPPORT PROVEN MALARIA INTERVENTIONS IN ALIGNMENT WITH THE NATIONAL MALARIA STRATEGIC PLAN (NMSP) 2011–2016 AND THE FOLLOW-UP PLAN OF THE MOH 7 OBJECTIVE 2: STRENGTHEN MANAGEMENT CAPACITY OF PROVINCIAL AND DISTRICT MOH PERSONNEL 21 OBJECTIVE 3: STRENGTHEN PROVINCIAL AND DISTRICT HEALTH MANAGEMENT INFORMATION SYSTEM (HMIS) TO IMPROVE DATA REPORTING 21 SUCCESS STORY 26 3 LIST OF ACRONYMS ANC Antenatal Care BRITE Broad Reach Institute for Training and Education CCI Community Champions Initiative CHW Community Health Worker CSO Civil Society Organizations DHO District Health Office DQA Data Quality Audit EDS Electronic Data System EHT Environmental Health Technician EPI Expanded Program on Immunization GRZ Government of the Republic of Zambia HCW Health Care Workers HFCA Health Facility Catchment Area iCCM Integrated Community Case Management ICEMR International Centers of Excellence for Malaria Research IPTp Intermittent Preventative Treatment in Pregnancy IRS Indoor Residual Spraying ITN Insecticide-Treated Net M&E Monitoring and Evaluation MACEPA PATH Malaria Control and Elimination Partnership In Africa MCH Maternal and Child Health MIP Malaria In Pregnancy MIS Malaria Indicator Survey MOGE Ministry of General Education MOH Ministry of Health MOP Malaria Operational Plan MRR Malaria Rapid Reporting MTEF Mid-term Expenditure Framework MTR Mid-Term Review NHCs Neighborhood Health Committees NMEC National Malaria Elimination Centre NMESP National Malaria Elimination Strategic Plan OPD Outpatient Department OTSS Outreach Training and Supportive Supervision PAMO Program for the Advancement of Malaria Outcomes PBO Piperonyl Butoxide PHO Provincial Health Office 4 PMI President’s Malaria Initiative RDT Rapid Diagnostic Test SBC Social and Behavior Change SMEO Surveillance, Monitoring, Evaluation and Operations Research TWG Technical Working Group WHO World Health Organization 5 PROJECT OVERVIEW Life of project September 30, 2015, to September 29, 2020 Reporting period July 1 to September 30, 2019 Target provinces Eastern, Luapula, Muchinga, and Northern Target population 5,455,218 (Source: Central Statistics Office, 2018) Implementing partners PATH (lead), Jhpiego, and BroadReach Institute for Training and Education Key partners Zambian Ministry of Health (MOH), National Malaria Elimination Centre (NMEC), Provincial Health Offices (PHOs), District Health Offices (DHOs) and health facilities. Malaria Control and Elimination Partnership in Africa (MACEPA), Churches Health Association of Zambia (CHAZ), and other United States Agency for International Development (USAID) implementing partners. Objectives (1) Support proven malaria interventions in alignment with the National Malaria Strategic Plan 2011–2016 and the follow-on plan of the MOH. (2) Strengthen management capacity of Provincial and District MOH personnel to provide supervision and mentoring for improved delivery of proven malaria interventions. (3) Strengthen Provincial and District health management information systems to improve data reporting, analysis, and use for decision-making. Contract number AID-611-C-15-00002 6 INTRODUCTION BACKGROUND The Program for the Advancement of Malaria Outcomes (PAMO) is a malaria activity program funded by the United States President’s Malaria Initiative (PMI) in Zambia. Designed to assist the Government of the Republic of Zambia (GRZ) in achieving as much progress as possible to reach its goal of eliminating local malaria infection and disease in Zambia, PAMO’s geographic focus is on four provinces: Eastern, Luapula, Muchinga, and Northern. These provinces are located in the northeastern part of Zambia and were selected due to the high malaria disease burden at project inception in 2015. Recent national surveys of malaria burden and intervention coverage show progress across the country in delivering interventions and reducing burden. While it appears that malaria prevalence among children under five years of age is declining, the results from the 2018 national Malaria Indicator Survey (MIS) indicate that apart from Eastern Province, the three other PAMO-supported provinces are still among the five provinces in Zambia with the highest malaria burden. The malaria prevalence rates in the PAMO-supported provinces justify the need for further investment in malaria control and elimination. In 2019, PAMO continues to work closely with the Ministry of Health (MOH) to further reduce the malaria disease burden in these four provinces. PAMO provides technical assistance and material support to strengthen the capacity of the government to improve malaria outcomes in the four PAMO-supported provinces and their districts. To that end, PAMO established and maintains effective partnerships with the National Malaria Elimination Programme (NMEP), provincial health offices (PHOs), district health offices (DHOs), health facilities, communities, civil society organizations (CSOs), and other stakeholders and partners to ensure effective and sustained implementation and scaling up of internationally and nationally accepted strategies to fight malaria. PAMO is currently in its fourth year of project implementation and this quarterly report covers activities implemented from July to September, 2019. BENCHMARKS AND ACHIEVEMENTS OBJECTIVE 1: SUPPORT PROVEN MALARIA INTERVENTIONS IN ALIGNMENT WITH THE NATIONAL MALARIA STRATEGIC PLAN (NMSP) 2011–2016 AND THE FOLLOW-UP PLAN OF THE MOH This objective has 13 Tasks aligned to the National Malaria Elimination Strategic Plan (NMESP) 2017–2021 in order to contribute to the overall MOH goals and objectives. This objective places an emphasis on key interventions such as sustained universal coverage of vector control interventions (distribution of long-lasting insecticide-treated nets [ITNs], indoor residual spray [IRS], and larval source management), case management (diagnosis and treatment), malaria in pregnancy (MIP), health promotion (community engagement and social and behavior change [SBC]), surveillance, monitoring, evaluation, and operations research. It is worth noting that, depending on the Task being implemented, PAMO directs its support at either the national or provincial/district level. Through Task 1.0 and 1.5, PAMO supports the NMEP at the national level by supporting national-level coordination, planning, and development of policies, strategies, and technical guidelines. Through the other tasks (namely Tasks 1.1, 1.2, 1.3, 1.4, 1.6, and 1.7), PAMO directs the bulk of its efforts to the sub-national level (i.e., by supporting the implementation of key NMESP interventions at provincial, district, health facility, and community level). TASK 1.0: STRENGTHEN NATIONAL TECHNICAL WORKING GROUPS (TWGS) PAMO provides technical and/or material assistance to the NMEP for national level technical working groups (TWGs). The national level TWGs for malaria are important structures that provide a platform to facilitate coordination and planning, and contribute to the development, dissemination, and mainstreaming of national strategic and technical guidance on malaria. There are four TWGs, namely, Vector Control; Case Management; Surveillance Monitoring, Evaluation and Operations Research (SMEO); and SBC. By supporting these TWGs, PAMO contributes to better- coordinated and harmonized implementation of the national strategy under the leadership of the NMEP. PAMO’s technical specialists and senior advisor of malaria, policy, strategy, and management play an instrumental role in these TWGs. During this quarter, all four TWGs met; highlights of these meetings are outlined below. 7 CASE MANAGEMENT TECHNICAL WORKING GROUP The case management TWG, noting with concern a surge in malaria cases in Lusaka and Eastern provinces, called on the two provinces to intensify malaria prevention activities. The two provinces also reported a large number of clinical malaria cases despite availability of diagnostic tools. It was recommended that the two provinces identify the reasons for this so that appropriate interventions can be put in place to support health care workers to ensure every malaria case is confirmed before treatment. Intermittent preventive treatment in pregnancy (IPTp): Another issue discussed was data showing low national uptake of IPTp. This was attributed to the stock-out of Sulfadoxine Pyrimethamine (SP) in all health facilities across the country. The TWG was informed that although the World Bank had initially planned to procure SP it was not procured because the funds that were allocated for SP were redirected to an emergency Ebola outbreak. However, the NMEP is still working to mobilize funds through other partners to procure SP and ensure access to and utilization of IPTp services. Outreach training and supportive supervision (OTSS): During the TWG meeting, the NMEP reported that
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