Malaria interventions coverage

Source: Sudan Household Health Survey (SHHS) & Millennium Development Goals (MDG) Indicators, Sudan, 2006

I. Epidemiological background

Parasite (Plasmodium) types	Plasmodium falciparum is the dominant parasite with more than 90% of all morbidity cases except in the border regions with Ethiopia where Plasmodium vivax also causes malaria infection although.
Main vector (mosquito) types	The major vectors are Anopheles gambiae s.s. and A. arabiensis and A. funestus but very little is known about their relative distribution in the country.
Total population	10,041,133 (2007)
Population at risk	10,041,133 (2007)
Women aged between 15-45 years of age at risk of malaria	522,139 (2004)
Children under five at risk of malaria	2,108,638 (2006)
Estimated Malaria episodes	4,339,487 (2007)
Malaria deaths (all ages)	131,790 (2005)
Child under 5 mortality (per 1000)	14,148 (2006)
Child under 5 malaria mortality	250 (2001)

II. Current Policy and Strategy

Primary interventions: Policy

Case management

Artemisinin-based combination therapies (ACTs) were adopted as the national policy as of 2004. Artesunate + Amodiaquine was selected as the first line and Artemether/Lumefantrine the second line for treatment of uncomplicated malaria. Quinine is reserved for the treatment of severe malaria cases. At peripheral health facilities, rectal Artesunate is the recommended pre-referral treatment for children with severe malaria. The IPTp guidelines recommend that least 2 doses of SP (at least one month apart) for pregnant women (in their 2nd and 3rd trimesters) and at least 3 doses for those known to be infected with HIV through ANC facilities.

Prevention

Eeffective malaria prevention as part of an integrated vector control strategy that utilizes all approaches including long-lasting insecticidal nets (ITNs), indoor residual spraying (IRS) and environmental management when and where most suitable and sustainable. At the current time in Southern Sudan, the priority intervention being focused on under this strategy is the promotion and distribution of ITNs.

IEC/BCC, social mobilization and advocacy

Delivery of LLINs and HMM will be enhanced through an intensive BCC programme. All sectors of society are mobilized to promote malaria control and increase adoption of positive behaviour, based on a comprehensive malaria communication strategy that includes all available media and communication channels.

III. Primary interventions

[+] ITNs distributed

[+] View data

Indicators	2003	2004	2005	2006
Malaria confirmed cases	631,004	515,958	337,582	116,385
ITNs distributed		45,000	253,000	650,000

IV. Challenges and Priority support needs (2008 - 2010)

Challenges in achieving SUFI: Weak health system Limited trained human resource within the programme No clear budget outline for the programme Weak coordination of partners at different levels Country wide shortage of commodities-ACT, ITN & RDTs Inadequate M&E and staff at various levels M&E and documentation of impact Weak drug procurement and supply management system Weak laboratory network system Lack of QC&QA and inadequate blood transfusion services To overcome these challenges, there is a need of: Deliberate move by GOSS/MOH to train large number of different cadres of health workers At central level, NMCP is better staffed with 3 of the 5 positions filled by national staff By 2009 all the ten states will have trained focal point for malaria Coordination at state and lower levels will be improving with 7 out of the 10 states now having full time malaria coordinator There are ongoing efforts on strengthening the M&E systems for health sector that have intensified the three main tools for data collection (e.g, IDSR, HMIS and household and facility surveys) Mass training of health workers: Contracts with three training schools was done Another contract with Health Training Institutes in Kenya and Uganda to recruit 300 students every year in specialized disciplines Target postgraduate training in specialized areas for Malaria strategies and new Malaria interventions Building the capacity of MOH/GOSS and state level in health systems planning and management Improving in management of existing staff Strengthening of national drug procurement and supply management system MOF will be responsible the public procurement and disposal in line with World Bank policies and procedures A technical firm has been contracted with funding from MDTF/World Bank and is closely working with the MCP on a wide range of technical areas including improved store management, setting up quality assurance, inventory management system and setting up computerized logistic information system

GOSS: Government of Southern Sudan

V. Key RBM Partners in Southern Sudan

• Ministry of health Sudan South
• WHO
• GFATM Sub-recipient NGOs
• MSH/USAID
• UNICEF
• World Bank
• PSI: Population Services International
• MC: Malaria Consortium
• JSI: John Snow Incorporate

Source: NMCP Southern Sudan

For questions, contact Ms Nadia Lasri, RBM Partnership facilitation
Dr J. Banda, RBM Partnership facilitation Coordinator,
Dr Othwonth Thabo, National Malaria Control Programme Manager

RESOURCES & LINKS:

Malaria Control Strategic Plan: July 2006 – July 2011

Malaria treatment protocols:
WHO Global AMDP database

Malaria contry profiles
World Malaria report 2005
WHO/EMRO

Online publications:
PubMed

Maps:
MARA/ARMA Sudan maps