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Impact

Community Involvement Drives Action Against Malaria in Guinea

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  • Community Involvement Drives Action Against Malaria in Guinea

USAID’s StopPalu+ project strengthens community health by building local capacity for sustainable progress against malaria.

Project Summary

Objective

Support Guinea in reducing malaria infections and deaths by 75% over five years compared to 2016 levels.

Approach

StopPalu+ partners with local governments, organizations, and communities to improve malaria prevention and care for the most vulnerable. Interventions include distribution of long-lasting insecticide treated nets (LLINs or bed nets), intermittent preventive treatment of malaria in pregnancy, trainings on and monitoring of malaria case management, malaria prevention among young children, and messaging activities.   

Impact

The project has strengthened community health by increasing community involvement and building local government and health provider capacity to monitor, prevent, diagnose, and treat malaria effectively.

Despite significant malaria prevention and control progress in recent years, malaria – called paludisme in French – continues to be the leading cause of illness and death in Guinea. More than 2.3 million cases of malaria were reported in this West African country in 2021 alone, with children and pregnant women being particularly vulnerable to contracting it. As part of the U.S. President’s Malaria Initiative (PMI), the USAID StopPalu+ project operates in half of Guinea’s 38 districts and 5 communes of Conakry to help the country drive down its malaria rates.

Leading Malaria Prevention and Control Efforts

By building on five years of progress achieved under the RTI-led USAID StopPalu project, StopPalu+ was able to quickly get to work to:

  • Increase use of long-lasting insecticidal nets (bed nets) to advance universal coverage
  • Increase use of preventive malaria treatments for pregnant women during antenatal care visits (ANC)
  • Increase prompt care-seeking and treatment among those infected with malaria 
  • Increase the number of children receiving a timely, full dose of seasonal malaria chemoprevention 
  • Increase community involvement in and support for malaria prevention and care
  • Improve the capacity of Guinea’s National Malaria Control Program (NMCP) to manage, implement, and monitor prevention, care, and treatment activities while using quality data for decision-making

The malaria prevention and control project aims to not only help Guinea fight malaria today, but build capacity at all levels to prevent, monitor, and treat it in the future too. By engaging communities and building local capacity, StopPalu+ ensures the gains it helps Guinea make today will last. 

A Local Approach to Preventing, Monitoring and Treating Malaria 

To help Guinea achieve its national goal of reducing malaria by 75%, StopPalu+ is partnering with local health providers and governments to provide training, tools, and support. The project trains community health workers on home visits, community case management (diagnosis, treatment, and referral of severe cases), and correct use of bed nets. It also helps local governments conduct seasonal chemoprevention and bed net distribution campaigns.

With training from the project, health providers have improved case management and treatment and integrated counseling on bed nets and preventive malaria treatments during pregnancy into healthcare visits. Training and support have also helped labs improve their detection and monitoring of malaria infections.

As a result, since 2018 local governments and health providers in the PMI zone have:

  • Delivered over 4.4 million bed nets to communities
  • Correctly diagnosed and treated malaria in nearly 2 million people
  • Given 3.7 million doses of preventive medicine to young children
  • Protected more than 500,000 pregnant women from malaria

StopPalu+ complements this support with creative, multi-channel social and behavior change communication (SBCC) activities that leverage the influence and authority of community and religious leaders to spread awareness of malaria prevention and encourage people to seek early treatment when infected.

Examples include:

  • Engaging 1,000 religious leaders to regularly spread messages about the importance and proper use of bed nets.
  • Featuring local community and religious leaders – both women and men – in radio and television broadcasts about malaria.
  • Engaging two well-known comedians in the country to produce radio and TV broadcasts on the importance of proper bed net use within the COVID-19 context.
  • Organizing more than 2,300 community dialogues and advocacy meetings on malaria and other health issues, such as COVID-19.

Community leaders share malaria prevention and treatment messages. [Credit: Sadak Souici / RTI International]

Focus on Community and Local Partners Drives Sustainable Malaria Prevention and Control

StopPalu+ is building the capacity of, and working through, five Guinean nongovernmental organizations. These partners are involved in all aspects of the project—from supporting community health workers in conducting door-to-door visits to monitoring the regular and correct use of bed nets, to disseminating key messages on preventive treatments and malaria case management, to collecting data to inform decisions.

The project also regularly conducts community dialogues to share what it has found during home visits and to recommend positive actions that improve health and well-being. Community dialogues help gather first-hand descriptions from the community members and leaders about their greatest challenges in the fight against malaria. In addition, they help community members feel they are part of the solution for malaria control and prevention and build trust in the project and the prefectural health officials, helping increase sustainability and self-reliance.

When COVID-19 hit, the project worked with local governments and local partners to adapt activities to the pandemic context, such as adapting a seasonal malaria prevention campaign to reduce the risk of spreading COVID-19 while still reaching young children with the vital medicine they needed to prevent malaria infection. StopPalu+’s established community relationships were also critical in communicating the importance of seeking timely treatment for fever, especially in the context of COVID-19 when many people were afraid to go to health facilities.

Guinea has drastically improved the completeness of its malaria data from 30% in 2013 to 100% in 2020. [Credit: Sadak Souici / RTI International]

Using Data to Inform Malaria Prevention and Control Interventions

StopPalu+ is using information and evidence to gather lessons and continuously adapt activities using a monitoring, evaluation, research, learning, and adapting (MERLA) approach. The MERLA approach uses monitoring and evaluation data as more than a reporting requirement; instead, it leverages programmatic data and adds operational research findings to drive planning, decision making, and implementation.

One major challenge is the lack of regular attendance by pregnant women of their health appointments, which are crucial for delivering preventive malaria treatments. The project conducted a study to identify areas with low attendance rates and propose solutions. StopPalu+ then developed activities to encourage pregnant women to keep their appointments, such as using SMS appointment reminders and educating female family members who could influence their pregnant daughters and sisters to attend visits.

The project is also building the capacity of health providers and leaders in Guinea to leverage data to make informed decisions. StopPalu+ has supported more than 2,000 monthly meetings a year for health centers and health districts to discuss data quality management and ensure it continues to improve, and with the project’s support, Guinea has drastically improved the completeness of its malaria data from 30% in 2013 to 100% in 2020. Having this quality data is critical, because it allows StopPalu+ to partner with district health teams to organize mobile clinics in communities with higher rates of malaria that are hard to reach.

Learn more about RTI’s work in malaria prevention, control and elimination.

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Clients

  • U.S. Agency for International Development (USAID)
  • U.S. President's Malaria Initiative

Partners

  • Jhpiego
  • Centre Africain de Formation pour le Développement (CENAFOD)
  • Medical Care Development International
  • National Malaria Control Program
  • Association pour la Promotion des Initiatives Communautaires (APIC)
  • Club des Amis du Monde (CAM)
  • Comité des Jeunes Mon Avenir D’abord (CJMAD)
  • Initiatives et Actions pour l’Amélioration de la Santé des Populations (INAASPO)
  • Solidarité Guinéenne pour le Dévelopement (SGPD)
  • Project C.U.R.E.

Our Experts

Aissata Fofana
Aissata Fofana Chief of Party
Jean-Luc Taton
Jean-Luc Taton Senior Project Manager
Erin Eckert
Erin Eckert Director of Infectious Diseases
Richard Reithinger Vice President, Global Health

Practice Areas

International Development Global Health

Countries

Guinea

More Insight

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Community Action Groups Lead the Way to Improved Health in Guinea

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Why Integrating Gender into Work to End Malaria is Critical: Lessons from Guinea

Insight

Continuing Work to End Malaria in Guinea During COVID-19: An Expert Interview with Dr. Aissata Fofana

Learn More

Working Alongside Religious Leaders to Prevent and Treat Malaria in Guinea

Toward "Universal Access" to Bednets in Guinea

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