About the project

The Plus Project is a 4.25-year Unitaid-funded project that will co-design, pilot, and evaluate country-adapted models of Perennial Malaria Chemoprevention (PMC) – the recent WHO recommendation which includes what was previously called Intermittent Preventive Treatment in infants (IPTi) using sulfadoxine-pyrimethamine (SP) in four focus countries: Cameroon, Benin, Cote d’Ivoire and Mozambique. Underpinning these PMC pilots will be training, routine monitoring, supervision, and community engagement activities integrated into existing country systems.
To generate evidence on the impact, effectiveness and cost-effectiveness of the different co-designed PMC models, a customized evaluation approach will be used with each focus country to generate data for policy work and decision-making. The project will collect limited data in three additional countries (DRC, Ghana, and Zambia) interested in adoption and scale-up of PMC.
Implementation experience and research evidence from the project will be shared with national, regional and global stakeholders aiming to support adoption and scale-up of PMC in the focus countries and other malaria-endemic countries of sub-Saharan Africa including through revisions to national policies and guidelines and early implementation experience of utilizing WHO’s recently updated PMC guidance.


Aligned with WHO’s recently updated guidance on chemoprevention, including PMC, the project’s approach to collaborative design reflects the shift to provide greater flexibility to National Malaria Programs to adapt control strategies to suit their settings. The Plus Project is partnering with government and other key stakeholders to design country-specific models of PMC for their context, including the number and timing of SP doses as well as the delivery channel. The PMC models in each focus country have been co-designed with key stakeholders of those countries and are a product of country-led ideation and decision-making.

The Plus Project is designed to work with and within the existing health system structures, leveraging existing points of contact between the health system and children under two to offer SP for PMC. The models co-designed by the government and national stakeholders include utilizing routine vaccinations and Vitamin A contacts delivered through both facility and community channels. Through implementation of these models, the Plus Project will aim to strengthen these delivery channels through supervision, support to routine M&E using MoH systems, and by offering training to providers and community health workers.


Brought to scale, PMC can help reignite progress against malaria in the Africa region, where 94 percent of all malaria cases and deaths occur each year. Progress in reducing malaria rates has plateaued in recent years and the COVID-19 pandemic has caused additional setbacks and interruptions to malaria efforts across the continent. Therefore, expanding an intervention like PMC, which is designed to be cost-effective and sustainable through integration into health systems, will have an impact not only during the life of the project but also beyond: the project will conduct a package of evaluations (including policy adoption receptivity evaluations, impact evaluations, economic evaluations, and process evaluations) that will generate evidence to inform policy and implementation guidance at the national and global level that will outlast the term of the project.





The Plus Project is led by Population Services International (PSI) with the London School of Hygiene and Tropical Medicine (LSHTM) in collaboration with key government and research partners. Together, they will support the project to co-design, implement, and evaluate different models of PMC, and to complete activities aimed at supporting the adoption and scale-up of PMC within and beyond the focus countries.