Zambia—MAMaZ Against Malaria (MAM)

Malaria is a serious public health problem in rural Zambia, particularly affecting children under 5. A variety of delays and barriers to successful treatment for severe malaria mean that incidence rates in Central Province between 2013 and 2015 were 495 per 1,000 children under 5 years.

The MAMaZ Against Malaria (MAM) project addressed the lack of access to quality commodities for case management of severe malaria in rural Zambia.

The project increased access to community-based pre-referral treatment for severe malaria for children from six months to under 6 years old, and to reduce referral delays from the community to health facilities that are equipped to treat severe malaria.

The goal of the project was to devise an evidence-based and sustainable strategy for improving the access of hard-to-reach communities to effective treatment for severe malaria.

The project generated evidence showing that it is feasible to provide pre-referral treatment for severe malaria in the communities and improve case management of severe malaria at lower-level health facilities.

MAM used a health systems and operational research approach to address the constraints that limit knowledge of severe malaria at community level and access to quality medical drugs which undermine effect case management.

Sample Activities

• Increase access to severe malaria commodities in remote areas.
• Intervene at the community level to reduce barriers and delays in treatment-seeking and increase patient completion of referral.
• Intervene at the facility level to optimize case management for severe malaria.

Select Results

• Provided proof that rectal artesunate administered in rural communities is a highly effective intervention for severe malaria among young children (6 months to 6 years old). The severe malaria mortality rate in this age group fell by 94.6 percent.
• Trained community health workers to mobilize their communities in support of a severe malaria agenda and to set up and manage systems to address the access and affordability barriers to services.