ZIMBABWE ASSISTANCE PROGRAM IN MALARIA QUARTERLY REPORT APRIL 1 - JUNE 30, 2018 ZIMBABWE ASSISTANCE PROGRAM IN MALARIA QUARTERLY REPORT APRIL 1 - JUNE 30, 2018 Recommended Citation: Year 3, Quarter 3 April–June, 2018 Report. Rockville, MD and Harare, Zimbabwe. Zimbabwe Assistance Program in Malaria, Abt Associates Inc. Contract and Task Order Number: AID-613-A-15-00010 Submitted to: United States Agency for International Development/President’s Malaria Initiative Submitted on: July 30, 2018 Abt Associates Inc. 1 6130 Executive Boulevard 1 1 Rockville, Maryland 20852 1 T. 301.347.5000 1 F. 301.913.9061 1 www.abtassociates.com CONTENTS Contents _____________________________________________________________________ i Acronyms ___________________________________________________________________ iii 1. EXECUTIVE SUMMARY _____________________________________________________ 1 2. BACKGROUND ____________________________________________________________ 1 3. ADMINISTRATIVE ACTIVITIES ________________________________________________ 3 3.1 STAFFING AND MANAGEMENT _________________________________________________ 3 3.2 CONFERENCES, RETREATS, TRAININGS AND MEETINGS ______________________________ 3 4. TECHNICAL ACTIVITIES _____________________________________________________ 5 4.1 MALARIA CM AND MiP _______________________________________________________ 5 4.1.1 Sending of SMS reminders to health care workers _________________________________________ 5 4.1.2 Malaria Clinical Mentorship ___________________________________________________________ 5 4.1.2.1 Selection of Mentors ____________________________________________________________ 5 4.1.2.2 Training of mentors _____________________________________________________________ 5 4.1.2.3 Commencement of malaria clinical mentorship visits __________________________________ 9 4.1.3 Mashonaland Central malaria death audit meeting _______________________________________ 11 4.1.4 Community CM ____________________________________________________________________ 12 4.1.4.1 Binga VHW training ____________________________________________________________ 12 4.1.4.2 Orientation of Health workers to VHW supportive supervision tools and processes _________ 13 4.1.4.3 Post training follow up and Supportive supervision ___________________________________ 15 4.2 LLINs _____________________________________________________________________ 22 4.2.1 Delivery of LLINs for CD _____________________________________________________________ 22 4.2.1.1 Training on use of rectangular nets _______________________________________________ 23 4.2.2 CD of LLINs _______________________________________________________________________ 27 4.2.3 Net Durability Study ________________________________________________________________ 28 4.3 SBCC _____________________________________________________________________ 28 4.3.1 Assessment of Drivers of Continuing Malaria Transmission in Angwa Ward, Mbire District, Mashonaland Central Province ______________________________________________________________ 28 4.3.2 Chikunda language malaria control Audio book for Chapoto ward in Mbire district, mashonaland central province __________________________________________________________________________ 31 4.3.3 SBCC Subcommittee meeting _________________________________________________________ 35 4.3.4 Community-based Activities __________________________________________________________ 36 4.3.4.1 CAC Refresher Course Training ___________________________________________________ 36 4.3.4.2 Matabeleland North CAC ToT ____________________________________________________ 37 4.3.4.3 Matabeleland North CAC District Sensitization (Binga and Hwange) _____________________ 37 4.3.4.4 CAC ACT-TOGETHER TRAINING IN MUTOKO DISTRICT _________________________________ 37 4.3.4.5 GOROMONZI OUTBREAK SUPPORT________________________________________________ 38 4.4 M&E/OR __________________________________________________________________ 41 i 4.4.1 Assessment of Drivers of Continuing Malaria Transmission in Angwa Ward, Mbire District, Mashonaland Central Province ______________________________________________________________ 41 4.4.2 Finalization of the National Malaria SM&E Plan __________________________________________ 41 4.4.3 Revision of the Epidemic Preparedness and Response Guidelines ____________________________ 41 4.4.4 Training of Health Workers in M&E ____________________________________________________ 41 5. Gender _________________________________________________________________ 42 6. Environmental Compliance _________________________________________________ 42 7. CHALLENGES and LESSONS LEARNED _________________________________________ 44 7.1 CHALLENGES _______________________________________________________________ 44 7.2 RECOMMENDATIONS AND LESSONS LEARNED____________________________________ 45 ANNEX A: PMP INDICATOR/YEAR 3 MILESTONE MATRIX ____________________________ 47 ii ACRONYMS ACT Artemisinin Combined Treatment ANC Antenatal Care CAC Community Action Cycle CD Continuous Distribution CM Case Management CCM Community Case Management CSBCC Community Social Behavior Change Communication DHE District Health Executive DHIS2 District Health Information System 2 DMO District Medical Officer DNO District National Office DPS Department of Pharmaceutical Services DQA Data Quality Assessment EHT Environmental Health Technician EPI Expanded Program on Immunization EPR Epidemic Preparedness and Response HCC Health Centre Committee HMIS Health Information Management System HW Health Worker IPC Infection Prevention and Control IPTp Intermittent Preventive Treatment in Pregnancy IRB Internal Review Board IRS Indoor Residual Spraying LLIN Long-lasting Insecticide-treated Net M&E Monitoring and Evaluation MIM Multilateral Initiative on Malaria MiP Malaria in Pregnancy MoHCC Ministry of Health and Child Care NDS Net Durability Study iii NMCP National Malaria Control Program OR Operational Research PEDCO Provincial Epidemiology and Disease Control Officer PEHO Provincial Environmental Health Officer PHE Provincial Health Executive PMD Province Medical Directorate PMI President’s Malaria Initiative PMP Performance Monitoring Plan PNO Provincial Nursing Officer RDT Rapid Diagnostic Test SBCC Social and Behavioral Change Communication SM&E Surveillance, Monitoring and Evaluation SMS Short Messaging Service SP Sulfadoxine-Pyrimethamine SS Supportive Supervision TBD To Be Determined TOT Train-the-Trainers USAID United States Agency for International Development VHW Village Health Worker ZAPIM Zimbabwe Assistance Program in Malaria ZDHS Zimbabwe Demographic and Health Survey iv 1. EXECUTIVE SUMMARY This report presents the third quarter of Year 3 performance of the Zimbabwe Assistance Program in Malaria (ZAPIM). It covers the period April 1-June 30, 2018. ZAPIM accomplished the following planned activities during this quarter: Sent short message service (SMS) reminder messages to 304 health care workers trained in case management (CM) and malaria in pregnancy (MiP) in Year 3 Trained 22 malaria clinical mentors from five districts (Mbire, Murewa, Mutoko, Hwange, and Binga) Conducted a malaria death audit meeting in Mashonaland Central Province Supported malaria clinical mentorship visits to 20 health facilities in four districts Trained 120 village health workers (VHWs) in CM and MiP in Binga Distributed registers, stationary, timers, satchel bags and T-shirts to 120 VHWs in Binga Oriented 48 health workers in VHW supportive supervision tools and processes in Binga and Hwange districts Held district VHW program review for Binga and Hwange Conducted post-training follow up of (279) VHWs in three districts (Binga, Hwange, and Mudzi) Conducted supportive supervision of 27 VHWs in five districts (Bindura, Centenary, Mt. Darwin, Mutoko, and Shamva) Delivered 35,100 long-lasting insecticide-treated nets (LLINs) to five districts (Bindura, Guruve, Mazowe, Mt. Darwin, and Shamva) for continuous distribution (CD) Distributed 25,153 LLINs through the CD channels. Will distribute the remaining nets, which are stored at various distribution points, next quarter. Delivered 4,000 LLINs to three districts (Binga, Beitbridge, and Chipinge) in response to malaria epidemics Introduced a pull system for ordering LLINs for CD by health facilities Trained 40 health workers and 268 VHWs on the use of rectangular nets Conducted an assessment of the forces behind continuous malaria transmission in Angwa Ward of Mbire District Developed and launched the Chikunda audio book on malaria control Supported and participated in social and behavior change communication (SBCC) subcommittee meeting held on June 8, 2018 1 Held a Community Action Cycle (CAC) refresher course for 35 CAC district facilitators Trained 10 CAC trainers in Matabeleland North Held CAC district sensitization meetings in Binga and Hwange Trained 11 health center committees on the CAC Act Together phase in Mutoko Provided SBCC support for outbreak response in Goromonzi Continued work on development of the malaria Surveillance, Monitoring and Evaluation (SM&E) Plan Review of the Malaria Epidemic Preparedness and Response (EPR) plan is currently ongoing Trained 51 health care workers on the SM&E plan in Mashonaland East Sent the senior case management specialist to attend a train the trainers (TOT) session on malaria elimination organized by the National Malaria Control Program (NMCP) Sent the M&E/operations research (OR) manager to attend a training on evaluation methods of malaria programs held in Ghana