1
|
Ali MH, Kitau J, Ali AS, Al-Mafazy AW, Tegegne SG, Ussi O, Musanhu C, Shija SJ, Khatib BO, Mkali H, Mkude S, Makenga G, Kasagama E, Molteni F, Kisoka N, Kitojo C, Serbantez N, Reaves E, Yoti Z. Malaria elimination in Zanzibar: where next? Pan Afr Med J 2023; 45:7. [PMID: 37538363 PMCID: PMC10395111 DOI: 10.11604/pamj.supp.2023.45.1.39804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/12/2023] [Indexed: 08/05/2023] Open
Abstract
In 2018, Zanzibar developed a national malaria strategic plan IV (2018-2023) to guide elimination of malaria by 2023. We assessed progress in the implementation of malaria activities as part of the end-term review of the strategic plan. The review was done between August and October 2022 following the WHO guideline to assess progress made towards malaria elimination, effectiveness of the health systems in delivering malaria case management; and malaria financing. A desk review examined available malaria data, annual work plans and implementation reports for evidence of implemented malaria activities. This was complemented by field visits to selected health facilities and communities by external experts, and interviews with health management teams and inhabitants to authenticate desk review findings. A steady increase in the annual parasite incidence (API) was observed in Zanzibar, from 2.7 (2017) to 3.6 (2021) cases per 1,000 population with marked heterogeneity between areas. However, about 68% of the detected malaria cases were imported into Zanzibar. Malaria case follow-up and investigation increased from <70% in 2017 to 94% and 96% respectively, in 2021. The review noted a 3.7-fold increase of the health allocation in the country's budget, from 31.7 million USD (2017/18) to 117.3 million USD (2022/23) but malaria allocation remained low (<1%). The varying transmission levels in the islands suggest a need for strategic re-orientation of the elimination attempts from a national-wide to a sub-national agenda. We recommend increasing malaria allocation from the health budget to ensure sustainability of malaria elimination interventions.
Collapse
Affiliation(s)
- Mohamed Haji Ali
- Zanzibar Malaria Elimination Programme, Ministry of Health, Zanzibar, Tanzania
| | - Jovin Kitau
- World Health Organization, Country office, Dar-es-Salaam, Tanzania
| | | | - Abdul-wahid Al-Mafazy
- Second Vice President Office-Zanzibar Country Coordinating Mechanism, Zanzibar, Tanzania
| | | | - Omar Ussi
- Zanzibar Malaria Elimination Programme, Ministry of Health, Zanzibar, Tanzania
| | | | - Shija Joseph Shija
- Zanzibar Malaria Elimination Programme, Ministry of Health, Zanzibar, Tanzania
| | - Bakari Omar Khatib
- Zanzibar Malaria Elimination Programme, Ministry of Health, Zanzibar, Tanzania
| | - Humphrey Mkali
- Population Services International, Dar-es-Salaam, Tanzania
| | - Sigsbert Mkude
- Population Services International, Dar-es-Salaam, Tanzania
| | | | | | - Fabrizio Molteni
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Noela Kisoka
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Chonge Kitojo
- US President´s Malaria Initiative, United States Agency for International Development, Dar-es-Salaam, United Republic of Tanzania
| | - Naomi Serbantez
- US President´s Malaria Initiative, United States Agency for International Development, Dar-es-Salaam, United Republic of Tanzania
| | - Erik Reaves
- United States Centers for Disease Control, Dar-es-Salaam, Tanzania
| | - Zabulon Yoti
- World Health Organization, Country office, Dar-es-Salaam, Tanzania
| |
Collapse
|