Sustaining Volunteers for Cross Border Malaria Elimination

On Sunday, July 31st, Constance Njovu, Regional Coordinator at the Isdell:Flowers Cross Border Malaria Initiative (I:F CBMI) delivered a presentation highlighting the Initiative’s success in sustaining volunteers for cross border malaria elimination efforts. 
 
Njovu presented at the 2nd South African Malaria Research Conference in Pretoria, South Africa. The conference, which brought together more than 200 members of the malaria community from 17 countries, provided researchers and organizations with the opportunity to showcase novel findings, innovation, ground breaking research, and ongoing collaborative efforts to eliminate malaria in Southern Africa.
 
Njovu manages a team of program staff in Angola, Namibia, Zambia and Zimbabwe, where 7 program managers supervise 34 field officers and nearly 900 community malaria volunteers (CMVs). CMVs are the backbone of the program, conducting community mobilization, monitoring and evaluation, active case detection, rapid diagnostic testing and treatment, and more. I:F CBMI focuses its efforts on border communities, where malaria is often transmitted across country lines.
 
By working in partnership with local and national ministries of health and other partners including the Anglican Church, The Global Fund, universities, The President’s Malaria Initiative, and MACEPA/PATH, I:F CBMI has contributed to a decrease in malaria incidence in the border areas, thanks in part to a robust and sustained volunteer base, shared Njovu.
 
Njovu presented the results of a qualitative study, which aimed to measure why CMVs stay. In order to answer this question, monthly meetings were conducted with CMVs within the border communities over the span of one year.
 
Results showed that 98 percent of CMVs were retained between 2014 and 2015. The qualitative research revealed that volunteers stay for a variety of reasons, including the sense of honour, respect, and recognition they gain for serving their communities. Additionally, the real time malaria incidence data CMVs receive encourage them to continue their work.  Lastly, incentives provided by I:F CBMI, including t-shirts, bicycles, and awards for strong performance, contributed to CMV retention.
 
An impact assessment also measured the CMVs’ contribution to malaria elimination in the border areas. Monthly monitoring of CMV performance and net usage was conducted and compared to local health data in order to examine whether increased net usage and strong CMV performance was associated with a decrease in malaria incidence. Results showed that CMVs were able to extend the reach of formal government and partner programs, contributing to a measurable and cost-effective impact on malaria control in these hard to reach areas. 

Health center data collected as part of the TKMI Harvard study shows a decrease in malaria incidence in the areas where CMVs are operating.

​Moving forward, Constance shared that I:F CBMI will sustain the gains already made by supporting local Ministry of Health data collection and intensifying community surveillance training for CMVs. Incorporating the volunteers into the local health systems will be key. For example, in the coming year, CMVs will be trained on community surveillance in four new districts within Zambia with support from the Ministry of Health and MACEPA. Managing malaria at the community level reduces costs and takes the burden off local health facilities, explained Njovu.