StopPalu+ President’s Malaria Initiative (PMI) Program Component Quarterly Report (Quarter 2, FY 2020) April 30, 2020 This publication was produced for review by the United States Agency for International Development. It was prepared by RTI International. StopPalu+ President’s Malaria Initiative (PMI) Program Component Quarterly Report January 1–March 31, 2020 Cooperative Agreement No. 72067518CA000015 Prepared for [REDACTED] Agreement Officer’s Representative (AOR) USAID/Guinea Telephone: +224.657.10.4433 [REDACTED] Submitted by [REDACTED] COP StopPalu+ RTI International 3040 East Cornwallis Road Post Office Box 12194 Research Triangle Park, NC 27709-2194 RTI International is an independent, nonprofit research institute dedicated to improving the human condition. Clients rely on us to answer questions that demand an objective and multidisciplinary approach—one that integrates expertise across the social and laboratory sciences, engineering, and international development. 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TABLE OF CONTENTS Page List of Figures ....................................................................................................................... iv List of Tables .........................................................................................................................v Abbreviations ........................................................................................................................ vi 1 Executive Summary ................................................................................................... 1 2 Introduction................................................................................................................ 4 2.1 Background.................................................................................................... 4 2.1.1 Malaria context in Guinea ................................................................... 4 2.2 Program Description ...................................................................................... 5 2.2.1 Project goal and objectives ................................................................. 5 2.2.2 Partners.............................................................................................. 5 2.2.3 StopPalu+ results framework .............................................................. 5 3 Activities by Result (IR) ............................................................................................. 7 3.1 IR 1: Increased Use of LLINs by the Population ............................................. 7 3.1.1 Sub-IR 1.1: Increased knowledge and skills of health care providers and community leaders on malaria prevention and the effectiveness, correct use, and care of LLINs ............................................................ 7 3.1.2 Sub-IR 1.2: Increase ownership of effective LLINs through continuous and mass distribution........................................................................ 13 3.1.3 Sub-IR 1.3: Increased awareness of family members of the need for vulnerable populations to be protected from malaria......................... 19 3.1.4 Lessons learned and proposed adaptations (IR 1) ........................... 23 3.1.5 Activities Planned for Next Quarter (IR 1) ......................................... 23 3.2 IR 2: Increased Use of IPTp During Antenatal Visits .................................... 23 3.2.1 Sub-IR 2.1: Improved technical capacity and interpersonal skills of providers .......................................................................................... 23 3.2.2 Sub-IR 2.2: Increased knowledge of women and other family members of the benefits of ANC visits, including IPTp ...................... 27 3.2.3 Sub-IR 2.3: Alternative approaches to improved access to IPTp services rolled out ............................................................................ 27 3.2.4 Sub-IR 2.4: Increased availability of SP and ancillary supplies ......... 28 3.2.5 Lessons learned and proposed adaptations (IR 2) ........................... 29 3.2.6 Activities Planned for Next Quarter (IR 2) ......................................... 29 3.3 IR 3: Increased Prompt Care-Seeking and Treatment .................................. 29 3.3.1 Sub-IR 3.1: Improved technical and interpersonal skills of providers in malaria diagnosis and care ............................................................... 29 StopPalu+—Quarterly Report—January to March 2020 iii 3.3.2 Sub-IR 3.2: Increased availability of quality diagnostic tests and treatment at facilities and community level ....................................... 43 3.3.3 Sub-IR 3.3: Increased knowledge and awareness by communities and family members of seriousness of childhood illnesses, key signs, and symptoms, and when treatment is ineffective ................................... 44 3.3.4 Lessons learned and proposed adaptations (IR 3) ........................... 45 3.3.5 Activities Planned for Next Quarter (IR 3) ......................................... 45 3.4 IR 4: Increased Full Dose of SMC Delivered in a Timely Manner ................. 45 3.4.1 Sub-IR 4.1: Increased awareness by community and family members of the need for infants and children under 5 to be protected from malaria ............................................................................................. 45 3.4.2 Sub-IR 4.2: Increased availability of SMC (SP+AQ) and commodities for continuous and mass distribution during high-transmission season in targeted districts ........................................................................... 47 3.4.3 Sub-IR Transversal 1. Increased community involvement in and support for malaria prevention and care ........................................... 49 3.4.4 Sub-IR Transversal 2: Improved capacity of NMCP (central, regional, district) to manage, implement, and monitor prevention, care, and treatment activities ........................................................................... 51 4 Project Management Activities................................................................................. 60 4.1 Project Deliverables ..................................................................................... 60 5 Other Activities ........................................................................................................ 63 6 Main Activities for the Next Quarter ......................................................................... 64 Annex 1: Performance Report for Quarter 2, FY 2020 (Jan–March 2020) ........................... 65 LIST OF FIGURES Figure 1: Malaria endemicity in Guinea ......................................................................... 4 Figure 2: Results framework ......................................................................................... 6 Figure 3: Availability and condition of LLINs in the 5 prefectures of Boké Region ....... 16 Figure 4: Use of LLINs in the 5 prefectures of Boké Region ........................................ 17 Figure 5: Availability and condition of LLINs in the 5 prefectures of Labé Region ........ 17 Figure 6: Use of LLINs in the 5 prefectures of Labé Region ........................................ 18 Figure 7: Availability and condition of LLINs in the 3 prefectures of Kindia Region supported by PMI ......................................................................................... 18 Figure 8: Use of LLINs in the 3 prefectures of Kindia Region ...................................... 19 Figure 9: IPTp round 3 coverage rate in the 5 communes of Conakry Region............. 26 Figure 10: IPTp round 3 coverage rate per commune in the 14 prefectures .................. 26 Figure 11: Average MDRT pre and post-test performance by region ............................ 31 Figure 12: Average microscopy performance by region during FY 2020 Quarter 2 supervision visits .......................................................................................... 34 iv StopPalu+—Quarterly Report—January to March 2020 Figure 13: Average performance trend in microscopic diagnosis in PMI zone in Quarters 1 and 2, FY 2020 ........................................................................... 35 Figure 14: 2019 SMC coverage rate per round and per district ..................................... 48 Figure 15: SMC coverage per round (cycle) .................................................................. 48 Figure 16: % of households who received a CHW visit during the previous month (Boké) .......................................................................................................... 56 Figure 17: % of households who have a good knowledge about malaria (Boké) ........... 56 Figure 18: % of households who received a CHW visit during the previous month (Kindia) ........................................................................................................ 57 Figure 19: % of households who have a good knowledge about malaria (Kindia) ......... 57 Figure 20: % of households that reported that they received malaria information through these main channels (Kindia) .......................................................... 58 Figure