GEMS+ 2020 ANNUAL REPORT
The Greater Mekong Subregion Elimination of Malaria through Surveillance (GEMS+) program supports national malaria programs in Cambodia, Lao PDR, Myanmar, and Vietnam to integrate the
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GEMS+
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.
NETWORK COVERAGE
Country-Specific Initiatives
How We Operate
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.
- Provider Network Management
- Comprehensive Training
- Commodity Supply
- Quality of Care
- Supportive Supervision
- Case Surveillance
TECHNOLOGY AND SURVEILLANCE
PSI INVESTS IN THE DEVELOPMENT AND ROLL-OUT OF INTUITIVE, INNOVATIVE TECH SOLUTIONS.
- PSI co-developed the Malaria Case Surveillance (MCS) app to allow providers to easily report cases as soon as they find them in an easy-to-use interface. Utilizing this real-time data collection from providers in the field, PSI is able to make informed decisions.
- The Health Network Quality Improvement System (HNQIS) tablet-based app was created to enable PSI staff to score provider performance against global best practice benchmarks, in order to provide immediate and constructive feedback to continue improving provider quality. HNQIS also helps our team know which providers need more assistance and can plan their supervisory support visits accordingly.
- PSI uses the District Health Network Information System (DHIS2) to house its electronic surveillance system, which allows for widespread access to data and user-friendly tools to visualize data in ways that facilitates decision making.
- PSI developed chatbots for popular messaging apps to allow doctors and pharmacists to report malaria cases, thus streaming critical health information from providers into national networks.
Our Impact
In 2020, GEMS+ achieved the following impact:
196,252
malaria tests conducted
1,147
malaria cases detected, treated and reported
131
Private Outlets Transitioned
Frequently Asked Questions
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.
annual reports
Resources
From Strong Malaria Surveillance to a Strengthened PHEOC
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Every Case Counts: Malaria Elimination through Private Sector Case Management
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Total Health System Malaria Surveillance
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In the News
The spread of artemisinin-resistant Plasmodium falciparum in the Greater Mekong subregion: a molecular epidemiology observational study
Malaria is getting bigger and badder — and we’re not ready for it
Malaria risk factors and care-seeking behaviour within the private sector among high-risk populations in Vietnam: a qualitative study
An assessment of national surveillance systems for malaria elimination in the Asia Pacific
Malaria and the mobile and migrant population in Cambodia: a population movement framework to inform strategies for malaria control and elimination
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