Achievements

ZAPIM Technical Areas

The ZAPIM project has 5 main technical areas of intervention, these include:

Malaria case management (CM) and malaria in pregnancy (MIP), community case management, social behavior change communication (SBCC), long lasting insecticidal nets (LLINs), and monitoring and evaluation (M&E), operational research (OR) and malaria elimination activities in Lupane District Matabeleland North Province. 

With an overarching goal of sustainable capacity building for the NMCP and in country partners, who we collaborate with at every step of the way.

CM and MIP

ZAPIM’s CM and MiP work focused on providing capacity building to health care workers with on the job mentorship, development of standard guidelines with NMCP for malaria care, and review and use of data for decision making. A total of 1,700 facility based health care workers from 15 districts were trained. ZAPIM led the revision and updating of the malaria treatment chart in line with the new treatment guidelines, revised epidemic preparedness and response guidelines and the accompanying training materials. The project developed and piloted an on the job malaria clinical mentorship program, trained 25 mentors and mentored 134 health facilities workers from 25 health facilities in five malaria high burden districts. The mentorship program spread beyond ZAPIM supported districts to include Global Fund supported districts.

Community Case management support focused on early access to treatment by training 1,464 village health workers (VHWs) in CM and MIP to ensure quality testing and treatment for malaria at community level. These were drawn from the 15 ZAPIM supported districts. The community case management training was complemented by post training follow ups, district level supportive supervision, environmental health technician (EHT) led supportive supervision and VHW review meetings. ZAPIM advocated for improved supply of commodities to VHWs and provided medicine cabinets to 200 VHWs in Mbire for safe storage of medications. The training of VHWs complemented with constant supply of commodities and medicines led to VHWs providing care to up to 50% of the cases of malaria seen in some high burden areas hence reliving pressure on the under staffed and strained health facilities. ZAPIM launched an ODK cellphone based reporting of malaria data in Mbire and provided 186 cellphones and met the cost for the reporting. This improved the completeness and timeliness of reporting.

LLINS

ZAPIM supported the NMCP in reviewing and updating the Mass Distribution and Continuous Distribution (CD) guidelines including the development of data collection and assessment tools. The project rolled out of CD of LLINs in 12 districts covering 116 health facilities. A total of 767 health care workers and 2096 Village health workers were trained on Continuous distribution of LLINs. 682 health care workers and 2671 village health workers were trained on Mass distribution of LLINs. Over the five year project period ZAPIM supported the distribution of 370,439 and 1,209,253 LLINs through the CD and mass distribution respectively. ZAPIM helped in tracking and collecting high quality data on distribution and use of LLINs in communities. To this end the project supported the NMCP in rolling out the electronic CD reporting system onto the DHIS2 platform by training 43 HWs from 12 districts. The projected spearheaded the distribution LLINs in hard to reach and special populations in Binga, Mbire and Rushinga Districts. In Mbire CD started in four health facilities in 2016. The contribution of the four health facilities to the malaria cases in Mbire reduced from 51% in 2015 to 27% in 2019 mainly due to use of LLINs in 4 implementation wards which had the largest burden of malaria in 2015.

SBCC

ZAPIM SBC support is focused at the national and community level, with a role on the national coordination of malaria messaging and then development and distribution of materials at the community level, based on the CAC cycle that identifies community level challenges with malaria issues and develops and implements plans to change behaviors or knowledge around malaria prevention, treatment and care. ZAPIM trained a total of 100 Health Centre Committees on the Community Action Cycle (CAC). As a result a total of 890 HCC members were capacitated on the CAC. These committees have managed to engage the communities in actively participating in malaria prevention and control activities. The main areas of focus have been encouraging early bookings by pregnant mothers, encouraging LLINs utilization and allowing their houses to be sprayed.

M&E, OR and Malaria Elimination Activities

M&E focused on support for collecting and using data for decision making at the national level by developing SM&E capacity building; PMI project specific indicators and OR as requested by stakeholders. Survey/studies supported during the project period included a Net Durability Study, Malaria Indicator Survey, Mazowe End Line Survey, Drug Consumption study and the Angwa Assessment.

Efforts to support malaria elimination in Lupane District included training of 25 frontline health workers (Environmental Health Technicians and Nurses) in the district in enhanced surveillance for malaria elimination, malaria case management in elimination, malaria cases classification and notification, foci investigation, classification, mapping, and response. Environmental Health Technicians in the district were trained in entomology, geographic information system (GIS) mapping of cases, breeding sites and the application of larvicides to mosquito breeding sites and monitoring of the same.