By Stella Abli, Communications Assistant, PSI Côte d’Ivoire; Erica Berlin, Malaria Technical Advisor, PSI
A Mother’s Experience
It is Wednesday, which means it is vaccine clinic day at the CSU Appoisso health facility in Abengourou, located in the Indénié-Djuablin region of Côte d’Ivoire. Mawa woke up early and walked several kilometers to reach the health center. A long journey on foot from her village, Mawa made the trek with her son Emmanuel, so that he could receive routine vaccinations as well as his second dose of Sulphadoxine Pyrimethamine (SP), administered through Perrenial Malaria Chemoprevention (PMC) efforts targeted at reducing the disease burden in children. She had previously heard about the importance of vaccinations from the community health workers (CHWs) who visited her village.
In June 2022, the World Health Organization (WHO) released updated guidelines on chemoprevention, noting that in areas of moderate to high year-round malaria transmission, children in high-risk age groups can be given antimalarial medicine through PMC at predefined intervals. The updated guidance builds on the previous WHO recommendation of Intermittent Preventative Treatment in Infants (IPTi), but adds flexibility on target age, number of doses and drug used, allowing National Malaria Programs to adapt control strategies to their settings.
Côte d’Ivoire has five PMC contacts and children receive SP at the same time as their regular vaccines and 18-month vitamin A dose. The Unitaid-funded Plus Project, led by Population Services International, is there to support the government in the deployment of PMC as well as in Benin, Cameroon, and Mozambique
During community visits, CHWs in Abengourou explain that vaccines can protect children from dangerous diseases like measles, polio, and pneumonia. Since February 2023, CHWs also relay how the new malaria prevention intervention, PMC, could help keep children safe from this deadly disease. From her CHW, Mawa learned how taking SP when pregnant prevented sickness, and now it can do the same for her son. Having understood SP for PMC is like a continuation of the Intermittent Preventative Treatment in Pregnancy (IPTp) intervention, Mawa brought her son for his first dose without hesitation. She mentioned that after the first dose, he “didn’t have any problems, he didn’t get hot, he didn’t have diarrhea, and he was healthy.” She was enthusiastic for her son to receive his second dose.
Working alongside the Ministry of Health, the Plus Project has supported the distribution of 31,000 doses of PMC in Côte d’Ivoire, with over 10,000 children having received their second dose.
Over 200,000 SP doses have been delivered across the four Plus Project focus countries: Benin, Cameroon, Côte d’Ivoire and Mozambique.
Raising Awareness through Community Health Workers
At the health facility, many women from surrounding villages were seated with their children awaiting their vaccinations. They had all gone through routine checkups, including weighing their child and checking for fever. Once all the women were seated at the vaccination post, Desiree, a midwife at the clinic, started a health education session teaching the women about SP for PMC.
CHWs have been trained in ways to raise awareness of intervention and ensure accurate information is shared with the mothers. Among them is Marcel, a 37-year-old father to four daughters, who loves “saving lives”. As a CHW in the Abengourou district, he strives to be a blessing for others. “The mosquitoes there bite them and then they get sick,’ explains Marcel. “But thanks to me when I’m going to give them mosquito nets, I’m going to tell them about medicines, the fact that they’re going to say, ‘he is a blessing for me,’ […] that’s everything to me.”
Marcel’s trainer Jacques Kossonou Kouakou, who is a nurse in the district, also shares the appreciation for serving his community. “Helping your community is self-giving […]. We don’t often realize it, but helping your community is helping yourself,” says Jacques. Jacques has trained many CHWs on SP for PMC. He is motivated to do the demanding work of a provider out of “the love for thy neighbor.” Impassioned by educating community health workers and raising awareness in his community, Jacques dreams of the day when malaria is eradicated. For Jacques, “a malaria-free future for the community, I mean that sounds like heaven on earth.”
*Names of caregiver and infant have been changed to protect their privacy.