Community health workers lead fight against malaria

A disease that kills children and pregnant women, the most vulnerable

By Proscovia Nakibuuka Mbonye
malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko
08 April 2020

Malaria is a life-threatening disease and currently the third largest killer of children after pneumonia and diarrhea, globally. In Uganda, malaria accounts for 14.5 per cent of under-five deaths. Children under five, pregnant women are more at risk of contracting the disease. When children contract malaria, their growth is affected and many die. Relatedly, malaria in pregnancy contributes significantly to deaths of mothers and their unborn children. Despite killing thousands, malaria is a preventable and treatable disease. 

To wipe out malaria in the most endemic districts of Northern, Eastern and the Karamoja sub-regions, UNICEF with financial assistance from UKaid is sensitizing communities on malaria prevention, testing and treatment. The activities are implemented under the Strengthening of Uganda’s Response to Malaria (SURMa) programme implemented by Malaria Consortium, UNICEF’s implementing partner in the districts of Otuke, Alebtong, Dokolo, Amolatar, Kaberamaido, Kwania, Apac, Oyam, Kole, Kitgum, Gulu, Agago, Nwoya, Lamwo, Pader, Amuru, Omoro, Kotido, Moroto, Abim, Amudat, Nakapiripirit, Napak, Kaabong and Nabilatuk.

Since the implementation of the programme, malaria cases among children under five and pregnant women have reduced, thanks to the tremendous work by the Village Health Teams who traverse communities to provide first line treatment of malaria, pneumonia and diarrhea as captured in the photographs. 

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

A chart showing malaria patterns in Oyam District, one of the high endemic and targeted districts for malaria interventions. With the interventions by Malaria Consortium, the curve has since gone down and a reduction in malaria cases registered. 

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

At one of the health facilities, Purongo health Centre III, in Nwoya District, Paul Okello, the Laboratory Technician in Nwoya, checks a blood sample from a baby to test for malaria. He confirms that - "In a day, a test about 40 patients and only 5test negative for malaria. The rest are positive” said David. This was before the interventions. 

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

Francis Komakech, a Village Health Team (VHT) members, prepares to do a malaria test for a one year and nine months old baby brought to his home. VHTs have been told that high temperatures do not necessarily mean one has malaria. A malaria test must be done to confirm, and treatment provided. To support the testing, all VHTs have been provided with the necessary equipment and can test for malaria for quick results and decisions taken instantly to save many children and mothers.

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

Francis Komakech gets a blood sample to do a malaria test on one year and nine months old baby brought to his home. Health services have been brought closer to communities through the VHTs that have been trained to manage malaria cases in their locations, keep records and treat children under 5 years when they test positive for malaria. "When a mother brings a sick child, I ask many questions. Does your child have cough, fever or malaria? Then I test for malaria and if it is positive, I give treatment. If it is negative, I refer them to health unit” said Komakech.

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

Janet Nyato a mother, fixes a mosquito net in her room. The communities have been provided with insecticide-treated mosquito nets and taught how to use them, by VHTs. Janet and her children now sleep under the protective nets and are safe from mosquitoes that carry malaria parasites. The VHTs also monitor them to make sure they follow the guidance.

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

Oliver Apio sits inside an insecticide-treated mosquito net with her 9 months old baby. The baby had just completed malaria treatment given to him by the VHT. Apio was provided with the net and taught that the net ‘catches’ the mosquitoes and kill them. Her baby has had 3 bouts of malaria and the VHT stressed to her that the dangers of the disease and requested them to sleep under the net for protection against the deadly mosquitoes. 

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

During a home visit in her area, Sumaya Awuma a trained VHT in Oyam District speaks to 21-year-old Cecilia Atim who is 8 months pregnant, about the dangers of malaria especially during pregnancy. “I also check her book to see if she has gone for antenatal visits, talk about sanitation, balanced diet and danger signs during pregnancy” says Sumaya.
 

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

Sumaya Awuma, uses health cards provided during her training, to demonstrate how a mosquito net is pitched, the importance of the mosquito net and the dangers of malaria in pregnancy. Atim is attentive and pledges to follow the advice provided. She previously had a miscarriage at only three months due to malaria. 

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

Felix Martin Olingo a VHT reviews the medical records book of one-month old baby of 20-year-old Juliet Awino, that he previously treated against malaria, during a home visit in his area. The VHTs make follow up visits to ensure the children have fully recovered from the disease. 

malaria in pregnancy, malaria, children under five, child health, maternal health
UNICEF Uganda/2019/Adriko

The VHTs also review the medical records of the children to ensure the medication is taken as prescribed as well as check on other health issues. The support provided during the home visits covers a wide range of health issues.