Addressing TB and malaria
Building on our long-term partnership with GSK to address high rates of tuberculosis (TB) and malaria in Kenya and Ethiopia.
Building on our long-term partnership with GSK
Malaria and tuberculosis (TB) together kill millions of people every year. Africa bears the greatest burden of these diseases, with 94% of global malaria deaths and more than a quarter of global TB deaths occurring in the region.
With this in mind, Amref Health Africa and GSK have teamed up in the latest iteration of our longstanding partnership to address malaria and TB in Ethiopia and Kenya: both high-burden countries where routine health services have been disrupted by the ongoing COVID-19 pandemic.
All images taken in Gambela, Ethiopia (c) Girma Berta for Amref Health Africa, 2019
Healthcare workers in Kenya have reported a 70% decrease in the number of people coming to facilities for TB testing, and 50% of people living with TB have reported difficulties in getting to facilities. In Ethiopia, emerging data have shown that the COVID-19 pandemic has resulted in a 66% reduction in TB case detection in both Addis Ababa and Dere Dawa City.
The programme aims to sustainably strengthen health systems in both countries. It will run for 20 months in Kenya (in six counties: Bungoma, Busia, Kakamega; Siaya, Homabay and Migori) and 12 months in Ethiopia (in 25 woredas across two regions, Afar and Somali), where it will build on an existing initiative. The programme will take a diagonal approach, addressing challenges at all levels of each country’s health systems: building the capacity of frontline health workers and health managers, enhancing community health systems strengthening, and strengthening TB and malaria surveillance to inform decision-making.
Malaria under COVID-19
Only a few years ago, the global health community was considerably more optimistic about efforts to eradicate malaria. But the COVID-19 pandemic has jeopardised, if not reversed, these gains.
Source: World Malaria Report 2021 (WHO)
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Watch Amref Health Africa's Group CEO, Dr Githinji Gitahi, explain why this project is so timely.
Our Impact in Kenya
In the first year of the programme:
- Start-up activities included a co-creation workshop, county project launches and an online event hosted by Devex, as well as a baseline assessment.
- The baseline findings were presented at a nursing conference in Tanzania.
- TB and malaria curricula content was revised and adapted for digital training. This was used to provide refresher training for 82 ToTs, train 360 healthcare workers (HCWs) and conduct continuing medical education (CMEs) for 1,816 HCWs.
- At county level, to support leadership and governance of management teams, 327 people were trained in leadership, management, and governance (LMG), 80 people on effective commodity management, and supported annual performance reviews for TB/malaria indicators. The project also supported the development of a Human Resources for Health (HRH) strategic plan in Homabay County and a Community Health Services (CHS) policy in Kakamega county.
- At community level, 120 health facilities and 96 Community Health Units received supportive supervision.
- A total of 1,199 community health volunteers (CHVs) enrolled onto digital malaria case management training and 129 community health extension workers (CHEWs) were trained on areas related to improving community participation.
- An awareness raising event was held on World Mosquito Day in Homabay County.
- To improve data for decision-making, a data quality audit (DQA) was carried out in Busia County, 18 ToTs were trained on data analytics, and CHV data reporting tools were digitised.
Building skills and knowledge
"We now have the skills and knowledge to manage patients as well as find more cases in communities, which is vital in eliminating TB," says Margaret Maureen Atieno, Sub-County TB Coordinator, Siaya County, Kenya, in this short film made for World TB Day in 2022.
Credit: Kennedy Musyoka, Amref Health Africa.
Our Impact in Ethiopia
Note: The conflict in Ethiopia has had an impact on 13 Amref-run projects across the Afar and Amhara Regions, both of which border Tigray. An estimated 2.2 million people living in Afar and Amhara have been affected by the conflict. 1,500 health facilities are non-functional due to destruction and looting, and many health professionals have been displaced, resulting in a significant disruption to services. Amref’s priorities are to ensure continuity of service delivery where possible and to support Public Health Emergency Management efforts as the situation evolves.
Despite these challenges, in 2021:
- The project commenced with Ministry of Health (MoH) registration and launch events in the two regions.
- 201 health workers were trained in malaria and 120 health workers received advanced TB training.
- A total of 120 health facility managers were trained as ToTs on Primary Health Care clinical guidelines, which is being cascaded to health facilities.
- 88 lab technicians were trained on lab quality management systems, 55 health facilities participated in External Quality Assurance (EQA) and 101 community health posts participated in on-site assessments for malaria rapid diagnostic tests (RDTs).
- At community level, mobile van TB services screened 311 people in Afar and 134 community volunteers were orientated in Somali on community-based activities in order to mobilise their respective communities.
- Finally, operations research was conducted in Somali to allow lessons to be drawn from integrating disease-specific activities into maternal and child health services.
Tuberculosis and malaria cause the highest morbidity and mortality among pregnant women and children in low-income countries like Ethiopia.
Evidence shows that the integration of TB and malaria programmes with maternal health and child health and HIV/AIDS services is very significant. The integrated approach improves the quality and coverage of care, enhances service uptake by avoiding missed opportunities, and increases client and health worker satisfaction through boosting health system efficiency.
Newsroom: Malaria vaccine breakthrough
Amref Health Africa welcomes the news that the WHO has given the green light for the roll-out of Mosquirix, a promising malaria vaccine developed by GSK and partners. Alongside other tools, it will be a vital asset in the fight to end malaria and improve child health in endemic regions.