GEMS+ 2021 Annual Report
Countries in the Greater Mekong Subregion (GMS) are successfully reducing the burden of malaria. Since 2010, there has been a reported 86% decline in cases
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Greater Mekong Subregion Elimination of Malaria through Surveillance
Countries in the Greater Mekong Subregion (GMS) are successfully reducing the burden of malaria. Since 2010, there has been a reported 86% decline in cases and 97% decline in deaths. Between 2019 and 2020 alone, the GMS region experienced a 47% decline in malaria cases. In the GMS 40-78% of the population first seek health care in the private sector, to achieve malaria elimination, we need sustained private sector engagement.
The Greater Mekong Subregion Elimination of Malaria through Surveillance (GEMS+) project supports national malaria programs in Cambodia, Lao PDR, Myanmar, and Vietnam to integrate the private sector into national malaria elimination strategies, surveillance systems, planning, and management structures.
In the initial phase of GEMS programming (2016 – 2019), PSI supported a diverse network of 25,000 private providers who tested over 3.5 million suspected cases and detected nearly 100,000 malaria cases. GEMS+, a 3-year follow-on to GEMS, represents an ambitious investment with the primary objective of transitioning private sector malaria programs to government oversight by 2023.
The GEMS+ program provides a comprehensive package of support to private providers within its network. Key components of support include: 1) training, supervising, monitoring, and motivating providers; 2) routine support to providers to test, treat, and report malaria cases; 3) ensuring availability of sub-national staff (both internally and in government) to support collection of paper forms, supervise, and monitor quality and 4) provider assessment through regular data analysis. Successful integration of the private sector into national malaria programs requires the development of national policies and strategies, allocation of resources by the government dedicated to the private sector program, and sustained engagement of transitioned providers. With private sector engagement in place, PSI supports national malaria programs to oversee and utilize the malaria testing and treatment services offered by the private sector as complementary to public facilities and community providers.
Over time, PSI is gradually reducing direct support to providers as national malaria programs increasingly assume ownership and oversight.
GEMS+ has identified six program components for transition to government oversight.
TECHNOLOGY AND SURVEILLANCE
In 2021, GEMS+ achieved the following impact:
malaria tests conducted
malaria cases detected, treated and reported
Private Outlets Transitioned
In Southeast Asia, between 40-78% of the population first seek health care in the private sector, meaning that private providers potentially see most of the malaria cases in the region. It is therefore critical that private sector outlets are able to test for malaria, and are stocked with the right drugs in order to provide correct treatment.
PSI works with the private providers that at-risk communities trust most. This includes doctors working at registered private clinics and pharmacies, as well as community health volunteers and non-formal outlets that can be a significant source of drugs and advice in some areas. GEMS+ supports national malaria programs to use local evidence (including case data from the public and private sector, national stratification, supervision, and quality assessment scores) to identify a manageable number of high-performing providers in high burden areas who make a measurable contribution to the national caseload.
Malaria elimination will fail without surveillance, and surveillance is incomplete without including data from the private sector. Without it, the government is not seeing the full picture.
PSI uses DHIS2, which is an open-source software allowing for greater access to data, and tools to help visualize data and automatically generate indicator calculations and reports. More information on DHIS2 can be found here.
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Program Expenses
Management, General, Fundraising Expenses
PSI partnered with the Medical Anthropology Unit of the Institute of Tropical Medicine, Antwerp (ITM) to conduct an anthropological study of forest-going communities to get deeper insight into their behaviors and barriers to health.
To follow national elimination surveillance protocol, 67 PSI private physicians were trained on SMS reporting within 24 hours of case notification.
PSI has developed an Emergency Operations Center (EOC) to improve preparedness and response to all public health emergencies, including malaria.
After Empathy-Insights-Prototyping (EIP) exercises with forest-goers, PSI is implementing mobile malaria workers on 166 worksites.
