Cambodia Malaria Elimination Project Quarterly Report (FY19 Q2) CAMBODIA MALARIA ELIMINATION PROJECT Cambodia Malaria Elimination Project Quarterly Progress Report - Year 3, Quarter 2 January - March 2019 Submission Date: April 30, 2019 Contract Number: AID-442-C-17-00001 Contract Period: October 26, 2016 to October 25, 2021 COR: Rida Slot Alternate COR: Noah Sprafkin Submitted by: Sharon Thangadurai, Chief of Party University of Research Co., LLC. #31, St 352, Sangkat Beugkengkang 1, Khan Chankamon, Phnom Penh, Email: [email protected] This document was produced by University Research Co., LLC (URC) for review and approval by the United States Agency for International Development (USAID). Cambodia Malaria Elimination Project Quarterly Report (FY19 Q2) TABLE OF CONTENTS Acronyms .............................................................................................................................. iv 1. Introduction ................................................................................................................. 1 2. Progress Toward achieving CMEP OBJECTIVES ...................................... 3 2.1 Objective 1: Develop a scalable, evidence-based elimination model in SPL OD and support its dissemination and replication for malaria elimination in Cambodia. .....3 2.2 Objective 2: Support scale-up of high quality malaria control and prevention interventions in five to eight ODs, where gaps in coverage or quality exist.................8 2.3 Objective 3: Strengthen national malaria surveillance systems and M&E appropriate for malaria elimination and control activities ............................................ 12 2.4 Objective 4: Build capacity of Ministry of Health (MOH) to manage, intensify, and sustain malaria control and elimination efforts particularly at the OD level .......... 14 3. Project Management .............................................................................................. 15 Oversight and Coordination ................................................................................................................................ 15 Procurement ........................................................................................................................................................... 19 Financial Management ......................................................................................................................................... 19 4. Resolving challenges from FY19 Q1 ................................................................ 20 5. Challenges and actions taken or proposed .................................................... 20 6. Plans for next Quarter and upcoming events ............................................... 20 ANNEX 1 CSO FY19 Q1 RESULTS TABLES ............................................................................ 22 ANNEX 2 - LAB QA/MICROSCOPY TRAINING TABLES ................................................ 26 i Cambodia Malaria Elimination Project Quarterly Report (FY19 Q2) ACRONYMS ACT Artemisinin-based Combination Therapies AOP Annual Operational Plan BKN Bakan BTB Battambang CMEP Cambodia Malaria Elimination Project CBO / CSO Community Based Organization / Civil Society Organization CDC Centers for Disease Control and Prevention CN Concept Note CNM Cambodia National Malaria Center COP / DCOP Chief of Party /Deputy Chief of Party COR Contracting Officer’s Representative EDAT Early Diagnosis and Treatment GUC Grants Under Contract HC Health Centre HF Health Facility HP Health Post IDQA Internal Data Quality Assessment IPC Interpersonal Communication IRB Institutional Review Board ITN Insecticide-Treated Net KRK Krakor LLIN / LLIHN Long Lasting Insecticidal Net / Hammock Net M&E Monitoring and Evaluation MEAF Malaria Elimination Action Framework 2016-2020 MMP Mobile and Migrant Populations MMW Mobile Malaria Worker MoH Ministry of Health MOP Malaria Operational Plan MRS Maung Russey OD / ODMS Operational Health District / OD Malaria Supervisor ODTL/ODTLA Operational District Team Leader / OD Assistant TL OEC Operation Enfant Cambodge PHD / PMS Provincial Health Department / Provincial Malaria Supervisor PKV Phnom Kravanh PLN Pailin PMI President’s Malaria Initiative PP Private Provider PPM Private Public Mix PMP Performance Management Plan RDT Rapid Diagnostic Tests SBCC Social and Behavior Change Communication SLDPQ Single Low Dose Primaquine SOP Standard Operating Procedure SPL Sampov Loun STA Senior Technical Advisor TMK Thmar Kaul UNOPS United Nations Office for Project Services URC University Research Co., LLC USAID United States Agency for International Development VMW Village Malaria Worker WHO World Health Organization i Cambodia Malaria Elimination Project Quarterly Report (FY19 Q2) 1. INTRODUCTION The USAID | PMI Cambodia Malaria Elimination Project (CMEP), 2016-2021, was launched on October 26, 2016 to support the Cambodian National Center for Malaria Control, Parasitology and Entomology (CNM) to reduce malaria morbidity and mortality and contribute towards malaria elimination goals nationwide by 2025. To reach this goal, the project has set up four strategic objectives to: 1. Develop a scalable, evidence-based elimination model in Sampov Loun OD and support its dissemination & replication for malaria elimination in Cambodia. 2. Support scale-up of high-quality malaria control and prevention interventions in five to eight ODs, where gaps in coverage or quality exist. 3. Strengthen national malaria surveillance systems and monitoring and evaluation (M&E) appropriate for malaria elimination and control activities. 4. Build capacity of malaria program to manage, intensify, and sustain malaria control and elimination efforts particularly at the OD level. Until Year 2 Quarter 2, CMEP implemented activities in four ODs in Battambang Province (Sampov Loun (SPL), Battambang (BTB), Maung Russey (MRS), Thmar Kaul (TMK)) and two ODs in Pursat Province (Phnom Kravanh (PKV) and Krakor (KKR)). During Year 2 Quarter 3 (April to June 2018), CMEP expanded to three additional ODs (two ODs in Pursat Province: Bakan and Sampov Meas, and 1 OD in Pailin Province: Pailin OD). Three transitional ODs graduated to elimination ODs (BTB, MRS and TMK), and Pailin was selected as an elimination OD. See Figure 1 for a summary of activity progress in FY19 Q2. In all 9 ODs, CMEP conducted the following activities in FY19 Q2: . 18,838 of suspected cases tested with 2,281 positive cases confirmed and all cases received appropriate treatment according to National Treatment Guidelines . Among the 5 elimination ODs in Battambang and Pailin province, 89% of all cases were notified within 1 day, 76% investigated within 3 days, and 73% responded to within 7 days (for SPL OD, 100% were notified within 1 day, 100% investigated within 3 days, and 100% respnded to within 7 days) . CMEP response to the increase in cases in Pursat ODs in FY19 Q2 continued and included monitoring daily/weekly cases, intensifying services at all points of care, and the continued setup and support of touchpoint/peer educator volunteers (there are now 6 touch point volunteers in KRK, 8 in PKV ODs, 5 touch point volunteers in KRK, 11 in PKV ODs) . Despite the changes due to the Private Provider ‘PRAKAS’, CMEP continued to support PPs in the areas of SBCC and referrals of suspected malaria patients . In the 5 elimination ODs, CMEP deployed 24,731 ITNs as buffer stock to VMWs in Q2 (target=14,600). Through VMW outreach activities, 14,977 ITNs were distributed (target=12,950) to local recidents and 3,031 ITNs (target=775) were distributed to PPMs through MMWs at big farms and MMP locations . In the 4 transitional ODs, 16,893 ITNs were deployed as buffer stock (target was 23,440) to the VMW level. 9,323 ITNs were distributed to local residents (target=13,425) and 330 ITNs were distributed (target was 480) to MMPs at big farms and MMP locations during outreach and response activities . Conducted systematic administration of single low dose primaquine for confirmed P. falciparum (Pf)/mixed cases (154 cases in all 9 target ODS). Supported CNM technical units to conduct 52 planned supervision visits (target=49). 1 Cambodia Malaria Elimination Project Quarterly Report (FY19 Q2) CMEPpittFY19Q2.xlsx Progress against each performance indicator is presented in the file attached. Figure 1. CMEP Summary of Activity Progress (January-March 2019) 2 Cambodia Malaria Elimination Project Quarterly Report (FY19 Q2) 2. PROGRESS TOWARD ACHIEVING CMEP OBJECTIVES 2.1 Objective 1: Develop a scalable, evidence-based elimination model in SPL OD and support its dissemination and replication for malaria elimination in Cambodia. Task 1. Pre-implementation situational analysis of current malaria elimination operations in SPL: Rapid Situational Analysis and Needs Assessment Report1: Task 2. Sustain universal long-lasting insecticidal net (LLIN) coverage: Mass distribution: There was no mass distribution activity in FY19 Q2 for Objective 1. Ensure continuous distribution of LLINs: In line with the updated list of villages for ITN distribution, CMEP’s target for continuous LLIN distribution was 201 villages in the 5 elimination ODs (partially due to an overall reduction of VMWs in elimination ODs in Q2) [Act 1.2.3]. Of these 5 elimination ODs, CMEP deployed 24,731 ITNs as buffer stock to VMWs in Q2 (14,600 planned). CMEP will further deploy ITNs in Q3, using USG-purchased ITNs. CMEP distributed 14,977 ITNs (12,950 planned) to target populations during outreach and response activities [Act 1.2.5] and