Success in malaria control and community mobilization
Between 2000 and 2009, Ecuador has seen a reduction of 96% in the number of reported malaria cases associated with intense malaria program activity. Today, only 4% of the 13.8 million people who live in Ecuador are at high risk for malaria.
The main interventions used to control malaria have been focused on Indoor Residual Spraying, Insecticide-treated net distribution, and early detection and treatment, which helped to cover almost 100% of the population at high risk. Malaria diagnosis and treatment are provided free of charge for all, and ACTs have been available for treatment since 2005.
The Global Fund approved US$ 7.2 million for malaria programs in Ecuador since 2005, but the government has traditionally provided the majority of funding for malaria, showing their strong commitment.
The program supported by the Global Fund is implemented by two Principal Recipients: the Ministry of Health of Ecuador and Corporacion Kimirina. While the Ministry of Health handles the procurement and distribution of long-lasting insecticidal nets and the treatment of malaria cases among vulnerable populations, Corporacion Kimirina and DYA (a civil society sub-recipient) are responsible for training key health personnel in health units distributed throughout the country. They also work on strengthening the response and awareness of malaria of vulnerable populations through community-based organizations.
Kimirina is an organization that uses the community mobilisation approach to decentralise malaria prevention and treatment. Coupled with tailored training of health personnel, it has allowed for primary health care units in risk zones to carry out detection, diagnosis and treatment of malaria; also taking care of follow-up, to ensure that people complete treatment.
Many of the communities reached by Kimirina are located in remote areas at risk of malaria, and have little or no access to health care facilities. They specifically target indigenous people, students, migrants and displaced persons located in areas closed to the Colombia’s border.
Their approach ensures that all grounds are covered, giving health promoters an important role to play: act as a link between the communities and formal health facilities. Health promoters are tasked to regularly visit communities to take blood samples and refer cases to the closest health unit to start treatment if malaria is suspected. They also help communities to set up local malaria management committees to raise awareness and organise clean-ups of mosquito breeding grounds; and identify community leaders to be trained to provide information on malaria prevention.
Over the past few years, Ecuador has seen a steep decrease in malaria cases and is a good example in the region as to how a combination of malaria interventions can help those in need: from training remote populations on malaria control, to strengthening government health facilities with capacity to diagnose and correctly treat malaria, health workers are saving more and more lives each day.