Malaria affects approximately half of the world’s population but the majority of deaths are concentrated among children under five in sub-Saharan Africa. PSI supports efforts to increase access to effective malaria prevention and treatment interventions, and works closely with ministries of health, primarily in Africa and Asia, to scale up proven interventions and sustain coverage over time. These interventions include: delivery of long-lasting insecticide treated nets (LLINs), long-lasting insecticide retreatment tablets, artemisinin-based combination therapies (ACTs), rapid diagnostic tests (RDTs), strategic behavior change communications and applied operational research. PSI uses multiple channels to deliver these interventions, including the public and private sectors and community case management strategies. PSI works in 32 malaria endemic countries, including 24 in Sub Saharan Africa. To date, PSI has delivered more than 150 million insecticide treated mosquito nets and more than 35 million malaria treatments. In 2011 alone, PSI delivered 43 million nets, representing roughly half of all nets delivered in Africa last year.
Healthy Lives through Partnership
As a result of the organization’s technical and operational capacity, PSI is acknowledged as a key implementing agency of the Roll Back Malaria (RBM) Partnership. PSI is an active member of the NGO delegation to the RBM Board and is a member of eight RBM technical working groups.
- Long Lasting Insecticide Treated Nets
PSI is a global leader in the delivery of long-lasting insecticide treated nets (LLINs), and supports ministries of health in more than 30 countries throughout Africa and Asia to achieve and sustain LLIN coverage. In 2011, PSI was involved in the delivery of about half of all the nets that were distributed in sub-Saharan Africa that year. To reach universal coverage, PSI distributes nets both for free and at highly subsidized prices through mass campaigns, routine health facility-based distributions, community health workers, and the private sector. Of the 150 million nets distributed since 1995, 52 percent were distributed via continuous distribution channels, such as antenatal care clinics and private sector retailers and 48 percent were distributed via mass distribution campaigns. Recent experience has shown that mass campaigns, while effective at scaling up coverage rapidly and equitably, must be complemented by strong continuous distribution systems that make LLINs available between campaign years in order to maintain coverage. In 2010, 95 percent of the LLINs that PSI distributed were given away for free.
- Artemisin-based Combination Therapy and Rapid Diagnostic Tests
PSI delivers artemisin-based combination therapy (ACT) drugs in conjunction with tailored health communication campaigns to ensure that those suffering from malaria have prompt access to effective treatment within 24 hours of the onset of symptoms. PSI distributes ACTs primarily through private sector and community channels to providers who are accessible to and trusted by caregivers. PSI works with local partners to train community health workers and medical providers on health promotion and malaria case management, in line with the integrated management of childhood illness (IMCI) protocol. PSI delivers ACT treatments in 13 high-burden countries including Nigeria, Tanzania and South Sudan. PSI also provides rapid diagnostic tests (RDTs) to facilitate correct diagnosis of malaria for children under five. RDTs allow trained health providers to better determine the cause of a child’s fever as malaria and provide the proper treatment. PSI distributes RDTs in Cambodia, Madagascar, Myanmar, Nigeria, and Uganda.
PSI leads the ACTwatch research project, a partnership funded by the Bill & Melinda Gates Foundation and the Global Fund which monitors anti-malarial markets in nine countries. The purpose of the ACTwatch project is to measure the impact of multiple interventions, including the AMFm in relevant countries, on the availability, affordability and use of ACTs in malaria endemic countries. It has also brought to light important data about the availability of largely ineffective monotherapies such as chloroquine and resistance-threatening oral artemisinin monotherapy in Africa and Asia. The ACTwatch research is crucial to better understanding how people access antimalarials, which treatments they receive, and the systems that supply them.
For more information, visit www.actwatch.info.
- Integrated Case Management
PSI contributes to global efforts to reduce child mortality by two thirds in 2015 compared to 1990 levels, by implementing integrated case management (ICM) programs that focus on treatment of pneumonia, diarrhea, malaria, and severe acute malnutrition. PSI is focused on improving access to effective treatment, enhancing quality of care, and increasing informed demand among caregivers to seek prompt and effective treatment from trained providers. To increase access, PSI works through pharmacy networks, franchised and non-franchised private clinics, and community health workers (CHWs) to reach caregivers of children under five with the quality services and commodities they need. By leveraging the most appropriate channel to reach caregivers, PSI will provide high quality, cost effective integrated health services that address the main causes of childhood morbidity and mortality in a given country.
Integrated Community Case Management (iCCM) is an ICM strategy to prevent child deaths in settings where access to facility based care is limited. PSI works with Ministries of Health to develop iCCM programs that involve clinical diagnosis and treatment provided by trained and supervised community health workers who promote timely treatment seeking, encourage appropriate home care, and facilitate referrals to facilities. In addition to improving access to care, PSI’s iCCM interventions focus on preventing child deaths by increasing quality of and demand for iCCM services. Children with danger signs are referred to health facilities. iCCM may include the treatment of malaria (with ACTs), pneumonia (with antibiotics) and diarrhea (with ORS and zinc). When CHWs diagnose uncomplicated malaria, pneumonia or diarrheal disease, treatment is provided free of charge. An iCCM intervention typically includes training and supervision of CHWs, appropriate treatment, and behavior change communications targeting mothers and caregivers. PSI implements iCCM programs in Malawi, Mali, DRC, South Sudan, Madagascar, and Cameroon, with funding support from CIDA, Global Fund, and other donors.