ZIMBABWE ASSISTANCE PROGRAM IN MALARIA ANNUAL REPORT REPORTING PERIOD: OCT 1, 2017 – SEPT 30, 2018 SUBMISSION DATE: OCTOBER 30, 2018 Recommended Citation: ZAPIM Year Three Annual Report, October 1, 2017–September 30, 2018. Rockville, MD, U.S., and Harare, Zimbabwe. Zimbabwe Assistance Program in Malaria, Abt Associates. Contract and Task Order Number: AID-613-A-15-00010 Submitted to: United States Agency for International Development/President’s Malaria Initiative Submitted on: October 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 LIST OF FIGURES ...................................................................................................................... iii LIST OF TABLES ........................................................................................................................ iv ABBREVIATIONS AND ACRONYMS ............................................................................................ vi 1. Executive Summary ........................................................................................................ 1 2. Background .................................................................................................................... 1 3. Technical Activities ......................................................................................................... 3 3.1 Clinical Case Management ...................................................................................................3 3.1.1 Entering of CM Training Data into Training System Monitoring and Reporting Tool (TrainSMART) Database ............................................................................................................................................................... 4 3.1.2 Malaria Clinical Mentorship Pilot............................................................................................................. 4 3.1.3 Malaria Death Audits ............................................................................................................................... 8 3.1.4 Supportive Supervision of Facility-based Health Workers ..................................................................... 11 3.2 Community Case Management .......................................................................................... 12 3.2.1 Post-Training Follow Up of VHWs .......................................................................................................... 13 3.2.2 Supportive Supervision of VHWs ........................................................................................................... 17 3.2.3 VHW CCM District Review Meetings ..................................................................................................... 21 3.2.4 Availability of Commodities ................................................................................................................... 23 3.3 Long Lasting Insecticide Treated Nets................................................................................. 24 3.3.1 LLIN Continuous Distribution Channels ................................................................................................. 24 3.3.2 Continuous Distribution Procurement and Supply ................................................................................ 25 3.3.3 Training on Use of Rectangular Nets ..................................................................................................... 28 3.3.4 Assessment of Ownership and Utilization of LLINs................................................................................ 30 3.3.5 Focus on Hwedza District ....................................................................................................................... 33 3.3.6 Net Durability Study ............................................................................................................................... 37 3.3.7 Lessons Learned ..................................................................................................................................... 39 3.4 Social and Behavioral Change Communication ................................................................... 40 3.4.1 Chikunda Language Malaria Control Audio Book .................................................................................. 41 3.4.2 Assessment of Drivers of Continuing Malaria Transmission in Angwa Ward, Mbire District, Mashonaland Central Province, Zimbabwe ........................................................................................................ 43 3.4.3 Commemorations and Events ................................................................................................................ 45 3.4.4 SBCC Technical & Planning Activities ..................................................................................................... 46 3.4.5 Community Action Cycle in high-burden malaria wards ....................................................................... 46 3.4.6 Community Advocacy Meetings ............................................................................................................ 54 3.4.7 LLIN Utilization Promotion in Goromonzi and Hwedza Districts ........................................................... 54 3.4.8 Goromonzi Malaria Outbreak SBCC Support ......................................................................................... 54 3.5 Monitoring & Evaluation/Operations Research .................................................................. 55 3.5.1 Case/Drug Consumption Study .............................................................................................................. 55 3.5.2 National Malaria SM&E Plan .................................................................................................................. 55 3.5.3 Epidemic Preparedness and Response Guidelines ................................................................................ 56 3.5.4 M&E Training of Health Workers ........................................................................................................... 56 3.5.5 Data Quality Assessments ...................................................................................................................... 57 3.5.6 Surveillance, M&E Subcommittee Meeting ........................................................................................... 59 3.5.7 Provincial Malaria Review Meetings ...................................................................................................... 59 i 4. Gender and Child Safeguarding ..................................................................................... 60 5. Environmental Compliance ........................................................................................... 61 5.1 Medical Waste .................................................................................................................. 61 5.2 Liquid and Solid LLIN Waste ............................................................................................... 61 5.3 Management of Public Health Medicines and Commodities ............................................... 61 6. ADMINISTRATIVE ACTIVITIES ........................................................................................ 63 6.1 Staffing and Management ................................................................................................. 63 6.2 Conferences, Retreats, Trainings and Meetings .................................................................. 63 7. Challenges, Lessons Learned and Recommendations ..................................................... 65 7.1 Challenges ........................................................................................................................ 65 7.2 Lessons Learned and Recommendations ............................................................................ 67 Annex A: LLINs Delivered by District, October 2017 – September 2018 .................................. 69 Annex B: Short-Term Technical Assistance ........................................................................... 71 Annex C: PMP Indicator/Year 3 Milestone Matrix ................................................................ 73 Annex D: Addendum on the Economic Situation in Zimbabwe .............................................. 90 ii LIST OF FIGURES Figure 1: Matabeleland PEDCO discussing their mentorship plan with the Binga team ... 5 Figure 2: Hwange District VHWs receive T-Shirts and Bags donated by ZAPIM ................. 13 Figure 3: Spaces used by VHWs for CCM ................................................................................ 15 Figure 4: VHW prepares to perform an RDT during post-training follow up ........................ 16 Figure 5: VHW showing off her neatly covered registers during post-training follow up .. 16 Figure 6: A Tip Tap facility in use at a clinic ............................................................................. 17 Figure 7: Review of VHW registers and gap identification........................................... 21 & 22 Figure 8: VHW commodity tracker ........................................................................................... 24 Figure 9: LLIN continuous distribution channels used in Zimbabwe, October 2017 – September 2018 ................................................................................................................... 25 Figure 10: Continuous distribution routes of LLINs 11
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