Malaria Control in Cambodia (MCC)

The Challenge

Due to efforts of the National Center for Parasitology, Entomology and Malaria Control and its partners, the number of malaria cases in Cambodia decreased by 51% between 1997 and 2009. Despite this decline, malaria still poses a considerable health burden, especially to high-risk groups such as forest workers, the Cambodian military, and refugee and migrant populations.

Overview and Objectives

The Malaria Control in Cambodia (MCC) Project, a community-based malaria control and prevention project, aimed to reduce malaria in the Western part of Cambodia, home to drug-resistant malaria. Funded by USAID Regional Development Mission for Asia, the project provided technical assistance and support to the Cambodian National Malaria Control Program (NMCP) in collaboration with Partners for Development and other non-governmental organizations involved in malaria control. The project sought to:

• Support the NMCP increase access to and utilization of insecticide-treated bed nets (ITNs);
• Support the NMCP improve access to and utilization of malaria case management services (public, private, and community);
• Strengthen managerial capacity at Provincial Health Department and Operational District (OD) levels;
• Improve standards for quality assurance and quality control methods for malaria microscopy and rapid diagnostic tests; and
• Collaborate in the development of policy and strategic interventions.

Achievements

During the first two years of the project, MCC distributed 22,000 USAID-funded long-lasting insecticide-treated nets (LLINs) to mobile and migrant workers and 5,000 USAID-funded LLINs to local villagers. MCC supported the distribution of over 200,000 ITNs and the re-impregnation of 16,484 bed nets. Over 30,000 people were reached with malaria prevention and treatment messages during national malaria week. Messages were reinforced through radio call-in shows, billboards, and other educational outreach.

In supported ODs, MCC trained health providers in malaria case management, including early diagnosis, rapid diagnostic testing, microscopy, and appropriate treatment of severe malaria. URC trained staff in logistics management and OD team leaders on project management and proposal writing. Also, in supported ODs, the percentage of labs with a functioning quality control system for malaria microscopy increased from 44% to 100%. Facilities supported by MCC maintained over 90% correct treatment for uncomplicated malaria cases and steadily improved management of complicated malaria cases.

URC supported expanding the role of village malaria workers (VMWs) to include diagnosis and treatment of uncomplicated malaria. Over 500 VMWs were trained to encourage community members to correctly use their bed nets and retreat them regularly, screen patients with rapid diagnostic tests and provide appropriate treatment. The proportion of confirmed malaria cases treated by VMWs doubled. And as a result, the number of severe malaria cases and the malaria case fatality rate reported by health centers declined, indicating that malaria patients were being diagnosed and treated earlier.