Bringing Down Mosquito Fever

Introduction

“This document is the result of a 14-day qualitative methods and “field story” writing workshop sponsored by Malaria and Childhood Illness NGO Secretariat (MACIS) in May 2004. Workshop participants, including staff members of the Adventist Development and Relief Agency International, Africare, AMREF, Christian Children’s Fund, Minnesota International Health Volunteers, THETA, Uganda Red Cross Society, and World Vision, sought to answer a number of questions surrounding home-based treatment of malarial fever that are not routinely documented by non-governmental organisations (NGOs) or academic journals.

These questions included:

• What happens when home-based management of malarial fever is implemented under real-life conditions, with few resources, communication outages, and low levels of training, in communities where annual per capita government expenditures on health are less than the cost of one dose of a new vaccine or an insecticide-treated
  mosquito net?
• Under such conditions, can home-based care truly increase access to prompt and appropriate treatment for children?
• Are parents actually learning to identify malaria in their children and promptly
  seeking medication from their local drug distributor?
• Are children with severe forms of the illness being referred to trained professionals?

As part of the workshop, MACIS members travelled to Kiboga District in central Uganda to interview and observe parents, volunteer drug distributors, traditional healers, outreach workers, government officials, and health center personnel. The group took extensive field notes and translated those notes into the journalistic story presented in the document. Though much of the story focuses on the work of AMREF in Kiboga, it is also representative of Africare’s work in Kanungu district and the Uganda Red Cross Society’s work in Kumi district.

Home-based management of fever due to malaria teaches mothers to identify the signs and symptoms of malaria and provides them with easy access to appropriate drugs. In Uganda, pre-packaged antimalarial medications are made available through volunteer drug distributors. Each packet of drugs, called a “Homapak,” contains enough chloroquine and sulfadoxinepyrimethamine to treat one episode of malaria in a child five years old or under.

Training mothers to treat childhood fevers with antimalarial medications reduced under-five mortality by 40% in Ethiopia. In Burkina Faso, early home treatment of malaria with pre-packaged drugs decreased severe malaria morbidity in children by 53%. On Africa Malaria Day in April 2002, Uganda became the first country to implement a large-scale programme for home-based management of malarial fever. This is currently the nation’s official malaria treatment policy.”