Sources consulted in the writing of this paper were PubMed, a report of the colloqium Health Care for All, held in Antwerp, Belgium, Oct 25–26, 2001 (ITM press 2002), and internal discussions with the malaria working group. Keywords used in searches were “malaria first-line health services”, “integration disease control”, “epidemic forecasting”, and “malaria-control strategy bednets”.
Personal ViewThe contribution of health-care services to a sound and sustainable malaria-control policy
Section snippets
Health services and malaria control
It is still unclear whether the GFATM will be able to collect and efficiently distribute the necessary financial resources for reducing the burden of AIDS, tuberculosis, and malaria. Nevertheless, considering the difficulties and limitations of organising disease-control activities in the context of existing health systems, only a long-term commitment will be able to achieve a substantial impact. Besides the performances of health services, drug-resistance monitoring, prevention through a
Malaria case management
In most countries, malaria case management is fully integrated into the existing health services. This trend has been strengthened by the introduction of Integrated Management of Childhood Illnesses (IMCI). Health services must be capable of managing most of the common diseases regardless of the local burden of malaria because this is just one of the several health problems affecting the local population. However, when considering that health services tend to be more and more decentralised, the
Prevention through insecticide-treated bednets
Insecticide-treated bednets (ITNs) can substantially reduce childhood mortality and morbidity in places where malaria is a major contributor to death. Intervention studies in four African countries32 estimated that six deaths per 1000 children can be prevented by ITN use. This intervention should be considered complementary to good case management and a primary form of prevention in much of sub-Saharan Africa. ITNs, by decreasing malaria morbidity, can reduce the workload of the health services
Malaria epidemics
In areas of unstable malaria the rapid detection of epidemics is greatly important for a rapid response. Adequate detection needs a reliable health-information system and well-trained and dedicated personnel. When these are missing, the consequences can be serious as illustrated by a malaria epidemic that occurred 20 years ago in South Africa. The epidemic was triggered by heavy rainfalls and was recognised too late because trained personnel were lacking.37 Indeed, the poorly developed
Conclusions
It is estimated that every year between one and two million people, mainly children, die of malaria, a large proportion at home without having been able to attend a health facility. Access to efficacious drugs is problematic, particularly now that resistance to commonly used drugs such as chloroquine and sulphadoxine-pyrimethamine is widespread. Moreover, adequate response to malaria epidemics is often delayed and has resulted in high mortality in countries such as Burundi, Ethiopia, Somalia,
Search strategy and selection criteria
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Neglected tropical disease (NTD) control in health systems: The interface between programmes and general health services
2011, Acta TropicaCitation Excerpt :While focusing on MDA, global NTD initiatives have largely ignored other manifestations of neglect, such as the social determinants and the (often weak) health systems (Spiegel et al., 2010). Nevertheless, there is a growing consensus that effective and sustainable NTD control requires well functioning health systems (Utzinger et al., 2009; Gyapong et al., 2010) and that weak health systems generally prevent progress in meeting disease-specific targets (Bellagio Study Group on Child Survival, 2003; Moerman et al., 2003; Travis et al., 2004; Koblinsky et al., 2006; Harries et al., 2009). Moreover, there are recent concerns that, like other global health initiatives (GHIs) addressing single disease issues (WHO Maximizing Positive Synergies Collaborative Group, 2009), mass campaigns may undermine health systems that are already fragile in countries with few resources (Singh, 2006).
Malaria treatment: no place like home
2009, Trends in ParasitologyCitation Excerpt :Malaria is a curable disease: prompt treatment with effective antimalarial therapy is a cornerstone of malaria control in sub-Saharan Africa [1]. However, in many areas, the capacity of the institutional health system to deliver a service of acceptable quality is limited by factors that include the lack of geographical access to health centres, inadequacy of health-care infrastructure and staffing, scarcity of affordable drugs and the poor performance of health personnel [2–5]. This is particularly evident in remote, rural areas in sub-Saharan Africa, where transmission of malaria is highest and where the majority of people at risk live.