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Mobilize Against Malaria

Mobilize Against Malaria

Overview

Mobilize Against Malaria (MAM) is Pfizer's signature philanthropic program to combat malaria. MAM is a five-year (2007–2011), $15M initiative announced at the Clinton Global Initiative in 2006, designed to address critical gaps in malaria treatment and education in Ghana, Senegal and Kenya.

The purpose of the MAM Initiative is to reduce malaria morbidity and mortality through the effective delivery of Artemisinin-based Combination Therapy (ACT), the national standard for treating uncomplicated malaria in Ghana, Kenya and Senegal. Each of Pfizer's three MAM programs uses a dual-pronged approach that addresses both the supply of quality public healthcare, as well as communities' demand for treatment. Specifically, MAM aims to:

  • Improve malaria symptom recognition, treatment, and referral through targeted training activities
  • Support complementary community mobilization campaigns to strengthen the demand for prompt and effective malaria treatment

In each of the three program countries, Pfizer provides support to leading non-governmental organizations (NGO) to implement and evaluate effective malaria interventions. These partners include Family Health International (FHI), Ghana Social Marketing Foundation (GSMF), Health Partners Ghana, Population Services International (PSI), KEMRI-Wellcome Trust and IntraHealth International.

Watch a short video about the role of Licensed Chemical Sellers in MAM Ghana.

Watch a short video documentary about MAM Senegal and some of the program's approaches and achievements on the ground.

Collaboration with Local and Global Partners

By working with partners on the ground, Pfizer is able to treat, teach, build, and serve communities affected by malaria. Uniquely, Pfizer also supports a multidisciplinary team at the London School of Hygiene and Tropical Medicine (LSHTM) to assist in developing strong and measurable pilot programs with potential for sustainable expansion through other funding organizations. Collaborating with the local implementation partners and evaluators, researchers at LSHTM facilitate the synthesis of cross-cutting issues emerging from the research, which are of strategic importance in the development of regional and global policy agendas on the delivery of health services.

Ghana: Over 1200 Licensed Chemical Sellers (LCS) trained to correctly dose and administer ACTs, and to recognize and refer complicated malaria cases to the nearest health facility in Ashanti Region, Ghana.

Kenya: Over 1600 staff working with pregnant women and young children trained to advise women on prevention and treatment of malaria in Nyanza and Western provinces, Kenya.

Senegal: Community health workers trained in malaria diagnosis and treatment at 24 health huts in Tambacounda, Senegal. All health huts were also equipped with furniture, basic medical and surgical instruments, health management tools, ACTs and notice boards.

Date: 2007–2011

The MAM Program in Ghana works with communities in the Ashanti Region to improve recognition and treatment of malaria. Photo credit: Mark Tushman
The MAM Program in Ghana works with communities in the Ashanti Region to
improve recognition and treatment of malaria. Photo credit: Mark Tushman

Mobilize Against Malaria in Ghana

In Ghana, Mobilize Against Malaria is implemented with technical assistance from partners Family Health International (FHI) and Ghana Social Marketing Foundation (GSMF), and evaluated by Health Partners Ghana (HPG). The program bridges the public and private sectors by training local Licensed Chemical Sellers (LCSs), small retail outlets that act as a major source of basic medicines, particularly in rural areas. MAM Ghana has demonstrated that both training LCSs and educating the communities they serve can dramatically improve malaria treatment, and prevention.

Through public awareness campaigns on the radio and through community meetings, families are learning the facts about malaria and why utilizing local healthcare is so critical. At the same time, over 1,200 LCSs in the Ashanti Region have received training and professional support and are developing closer ties to their communities. A survey of LCSs trained by the program showed a measurable change in the number of LCSs recommending ACTs (14% in 2009 up to 72% in 2010).

Mark Tuschman photo
A mother visits her local LCS in Ashanti Region, Ghana

Who are Licensed Chemical Sellers?

You can find LCSs in almost every community throughout Ghana. Registered and licensed through the Regional Pharmacy Councils, LCSs are small retail outlets that act as a major source of basic medicines for many, especially in rural areas. While LCSs play a major role in the community's healthcare system, shopkeepers and their staff are not formally trained healthcare providers. The aim of the MAM program is to empower LCSs throughout the Ashanti region to play a leadership role in their community's healthcare.

FHI and GSMF are working directly with LCSs to train them in using structured questions to obtain critical information from customers-such as a patient's age, symptoms and their duration-before dispensing medicines. LCSs learn how to correctly dose and administer ACTs and are trained to recognize and refer complicated cases to the nearest health facility.

"I was skeptical about the referral system until I had a case of severe malaria in a certain little girl. I filled [out] the referral form for the mother to take her to Tafo district hospital immediately. I was amazed when the mother later came back to thank me for helping to save her daughter's life. Previously, who was I to formally refer any case to the hospital? But now I can distinguish between complicated and uncomplicated malaria and refer when necessary."

– Mr. Paul Ofosuhene, LCS in New Tafo

Family Health InternationalGhana Social Marketing Foundation
Health Partners Ghana

Mobilize Against Malaria in Kenya

In Kenya, Pfizer has worked with Population Services International and KEMRI-Wellcome Trust on reducing malaria in pregnant women and children under five, two groups most at-risk of malaria-related mortality and morbidity. Recognizing that more than 70 percent of women attend antenatal clinics at least once during their pregnancy, MAM Kenya provides a boost to health workers and patients at these clinics with improved training, health education, and new information packages designed especially for new mothers.

To date, more than 1,500 healthcare providers have received the new training. MAM Kenya also works with mothers and caregivers of children under five at the community level, teaching them how to self-assess and recognize malaria symptoms. Radio campaigns and community meetings have already reached more than 12,000 parents and caregivers.

Working with Local Stakeholders for Effective Program Tools

Kenya is one of the first five African countries to adopt Intermittent Preventive Treatment for malaria in pregnancy (IPT-p) as a national policy. Since its implementation, Kenya has seen promising success in reducing the malaria burden in pregnant women. With an emphasis on antenatal clinics in Nyanza and Western provinces, the MAM program is collaborating with Kenya's Ministry of Health to integrate malaria prevention and treatment with standard antenatal services. PSI is also working with local officials to identify and address inequitable gaps in coverage where the poorest and most vulnerable women are unable to access quality care.

In partnership with local stakeholders, MAM Kenya developed a comprehensive training program for antenatal healthcare providers in each province. Through a regional working group convened by PSI, training curriculum and messages were developed and customized specifically for staff working with pregnant women and young children. The training emphasizes how to recognize malaria symptoms and improve the quality of Artemether-Lumefantrine (AL) services, a critical ACT treatment, while effectively promoting prevention on an ongoing basis.

The differentiating factor between the new curricula and that of the past is its focus on simplicity. Based on input from patients themselves, materials are easy-to-read and understand, making them well-understood by pregnant women and supporting long-term behavior change in women before, during, and after pregnancy.

Click on the MAM Kenya program tools to see an example of health worker training materials.

Population Services International   Kenya Medical Research Institute

Mobilize Against Malaria in Senegal

In Senegal, Pfizer works in partnership with IntraHealth International to strengthen the system of community health huts in Tambacounda region. Health huts are rudimentary clinics that are often the only healthcare facility accessible to rural communities. Recognizing the critically important role these health huts play in the country's healthcare system, Pfizer and its partners are investing in improving the infrastructure of health huts, 24 of which have been equipped with furniture, basic medical and surgical instruments, health management tools, ACTs, and notice boards.

IntraHealth builds the capacity of community health workers operating at these health huts to improve their ability to effectively diagnose and treat malaria, manage side effects of treatment, help patients understand the importance of compliance, and recognize cases requiring referral to the nearest hospital.

A community health hut in operation in Tambacounda, Senegal
A community health hut in operation in Tambacounda, Senegal

From Fever to Anti-Malarial: the process of seeking and receiving appropriate treatment in rural Senegal As part of MAM Senegal, LSHTM researchers undertook a household survey in Tambacounda. The aim was to investigate the pre-intervention treatment-seeking practices of parents and caretakers of children under five years who had presented with a fever in the previous two weeks. Researchers used multivariate logistic regression to find out what determined caretakers' actions at different stages in the process of seeking and receiving treatment.

The proportion of caretakers seeking treatment for their children at a community-level delivery point was only 7.8%. This was low compared to 31.5% of caretakers who sought medical attention at a formal public health facility, and 17.0% who accessed informal or private healthcare. However, children whose caretakers sought treatment at a community-level delivery point were four times more likely to receive the appropriate anti-malarial than those who first sought care in the formal public sector.

Given the right investment in infrastructure, training and education, this research indicates the potential impact of community health huts as a reliable and accessible source of healthcare.

Click on YouTube link to see the MAM program working with communities in Tambacounda, Senegal

IntraHealth International, Dakar, Senegal