BUJUMBURA April 4th (ABP) – Senegal’s expert from the World Health Organization (WHO), Dr. Bacary Sambou, during a workshop to present the results of the performance review of the National Integrated Program for Malaria Control (PNILP 2013-2017) organized on Friday March 30th at the Royal Palace Hotel, proposed a new strategic direction to effectively fight against malaria.

Following the evaluation of the implementation of PNILP activities, the results show that malaria is still a health problem in Burundi, despite the efforts of the government and its partners in setting up the PNILP. A persistent pattern of malaria has been observed and, as a result, morbidity and mortality are a major socio-economic burden for households and the country as a result of direct and indirect expenditure related to consultations and hospitalization, travel by sick and nursing, absence at workplace, food, funerals and others.

According to Dr. Sambou, the persistence of malaria in Burundi is caused by various challenges that the PNILP has encountered. This is the long process of acquiring inputs on the financing of the State budget, the weak functionality of the health product registration process, and the import control of the private sector; quality in post of unrealized marketing, pharmacovigilance still at the embryonic stage, as well as weakness in the coordination of the actors. To this list, Dr. Sambou adds the non-development of the plan for the implementation of community-based interventions, and the failure to carry out activities of promotion and community monitoring for the use of distributed insecticide-treated mosquito nets.

As for vector control, Dr. Sambou says that despite the coverage rate in insecticide-treated mosquito nets of 91-93% in the epidemic risk facilities that are Cankuzo, Muyinga, Buye, Gashoho, Buhiga, Nyabikere, Murore, Gihofi and Rutana, as well as the updating of the distribution map, the related salient challenges are noticeable. There is the lack of evaluation of the impacts of the strategy and the acceptability of the measures by the beneficiary people, and the lack of management of the increasing resistance of the vectors of insecticides to several families.

With regard to monitoring and evaluation, expert Sambou mentions the absence of a doctor epidemiologist and a data manager, the limitation in the geographical information system, the absence of the manual of procedures for surveillance and monitoring and evaluation and others as challenges that contribute to the persistence of malaria. Added to this is the absence of the forecasting and prevention system, the delay in decision-making and actions, the absence of the overall epidemic management plan, as well as the low coverage of epidemics in the budget from the different grants.

To all those challenges, Dr. Sambou gives five strategic axes to fight effectively against malaria in Burundi. He insists on the involvement of the State in the fight against malaria especially by increasing funding, strengthening the process of control over the importation of health products, as well as the implementation of national guidelines on quality assurance of drugs. For the prevention axis, Dr. Sambou proposed scaling up and expanding malaria prevention by involving other Ministries. For the treatment component, he suggests the availability of inputs, the involvement of the private sector and community-based interventions, without forgetting the chemoprevention oriented by operational research.

Before proposing the strengthening of the national system of surveillance, monitoring and evaluation, a quality operational research system and the preparation of immediate responses to epidemics and other emergencies, Dr Sambou talks about strengthening the communication among the actors and beneficiaries to change behavior. He concluded by recalling to update the stratification of the country, as the old one dates back from 1998.

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