In the fight against malaria in Uganda’s Ntungamo district, Village Health Teams (VHTs) are playing a vital role. Banzimbana Phenehasi, a VHT based in Kabingo village, Nyamunuuka Town Council, is one such individual. He is among the over 1000 VHTs that were trained by the Ministry of Health with support from (United Nations Children’s Fund) UNICEF and other partners with funding from the Foreign, Commonwealth and Development Office in Integrated Community Case Management (iCCM) equipping them with skills to support the community in managing various preventable and treatable diseases.
He carries out his activities, with the aim of supporting health workers in providing health services, including health education, patient referral, malaria Rapid Diagnostic testing (RDT), treatment among others.
In Kabingo Village, Phenehasi is responsible for about 45 households, and he has been doing this for the last three years.
On a sunny Thursday afternoon, upon being notified of a sick child in one of the homes belonging to Esther Nakachwa, which comprises four children, three of whom are under the age of 5, within his village, Phenehasi made his way to ascertain the problem.
“My son has had a fever for about seven days, and I think he might be down with malaria,” says Nakachwa, upon an inquiry from Phenehasi.
“I was trained by Ministry of Health and UNICEF, and I have a better understanding of my work now. My work is cut out for children below five years and pregnant women and I am tasked to deal with fever, pneumonia, diarrhoea, and malaria.”
Says Phenehasi
Using malaria RDTs, Phenehasi tested Esther’s son who presented with fever, however, fortunately the results were negative for malaria, and thus he referred them to Bwongyera Health Center III to which he is attached. He also educated the family about malaria prevention and control at the household level.
“Most of my village mates are not sure of how malaria presents, and due to the high number of mosquitoes in this area, I have to run a RDT to ascertain if malaria is affecting them. When I find them positive, I prescribe Coartem according to their age,” Phenehasi reports.
Coartem is an anti-malarial medicine used to treat certain types of malaria infections. It destroys the malaria parasites (tiny organisms consisting of a single cell that are found inside the red blood cells).
Phenehasi further highlights that upon arrival at the homes, in addition to running the tests and prescribing medication, he educates household members on malaria prevention methods which include clearing bushes, closing windows and doors early enough, and the proper use of mosquito nets.
Mosquito nets play a significant role in preventing malaria as they protect children and pregnant mothers from mosquito bites, which are known to spread malaria.
Phenehasi further highlights that upon arrival at the homes, in addition to running the tests and prescribing medication, he educates household members on malaria prevention methods which include clearing bushes, closing windows and doors early enough, and the proper use of mosquito nets.
Mosquito nets play a significant role in preventing malaria as they protect children and pregnant mothers from mosquito bites, which are known to spread malaria.
To ease their work, UNICEF availed VHTs with smart phones installed with a mobile phone application called the ‘VHT APP’. “We use this application to register and track households, register their health statuses, and follow up when time is right,” notes Phenehasi.
He further points out that he has noted a reduction in malaria cases as of April 2023. “Out of every ten children I test, I find only two to three children positive with malaria.
Gerald Twesiga, the Ntungamo district malaria focal person, agrees with Phenehasi, noting a significant decline in malaria cases.
“For instance, we have noted decline in the trend compared to the last quarter of 2022. Currently, according to Ntungamo district monthly malaria report, we recorded 3995 malaria cases by March 2023 compared to 8297 cases malaria in December 2022,” Gerald reports.
This, he alludes to the interventions by the government and partners, including building capacity of VHTs, provision of RDTs, provision of nets, and improved case management at health facilities.
Mr. Twesiga also adds that, while all the interventions played a significant role, the training of VHTs in iCCM played a vital role in averting the number of cases in the district.
According to the Annual Health Sector Performance Report for the financial year 2021/2022, malaria was still the leading condition among all outpatient diagnoses for all ages accounting for 32.1% of all OPD attendances. The number of malaria cases increased by 5% from 13,604,703 in 2020/21 to 14,904,773 in 2021/22.
The report further also notes that although the malaria incidence increased from 302/1000 to 317/1000 population, with an increase in malaria admissions by 16.6%, the number of malaria deaths reported reduced by 15% from 5,017 to 4,245. This may be attributed to early detection and improved case management as well as Integrated Community Case Management (ICCM) for children under 5 years.
According to Sarah Achen, the Programme Officer for Malaria at the UNICEF Field office in Mbarara, the role of VHTs in supporting the district health teams and partners to tackle malaria cannot be overstated.
“They know the people and know all the corners of the district and through them we are able to reach households with not only the right messages, but the right interventions to prevent the spread of malaria and treatment in case of any cases.”
“UNICEF is not only committed to eliminating malaria in Uganda but also to supporting other health initiatives such as nutrition and sanitation, including toilets, clean water sources, and boiled water,” she adds.
For Esther, the reduction of malaria in her household is a breath of fresh air. “Managing a sick child is not easy, and for that reason, I use my nets diligently and ensure that I visit Bwongyera HC III in case of any health need,” she says.
Mary’s children look healthy and energetic!
For this year’s World Malaria Day, commemorated under the theme, “Time to deliver zero malaria: invest, innovate, implement” UNICEF calls for concerted efforts towards a malaria-free world. The slogan “our collective responsibility” reminds us that it is not just the responsibility of governments and organizations, but of every individual to contribute to the fight against malaria.
