Lydia Nambiro, 32, is a mother of three who lives in a village in Kenya’s Lake Victoria region, where malaria prevalence rates are particularly high at 38 per cent. Despite a decreasing malaria rate in the country over the past five years, this area remains a hot spot and many in Lydia’s village die from this preventable disease.
“My daughter Nekesa is two and a half years old. She has been experiencing fever, headache and joint pains. Her appetite has declined since yesterday,” Lydia tells a community health worker. “I suspect she has malaria.” The health worker tests Nekesa for malaria using a rapid diagnostic test.
The Kenya Red Cross Society is a key partner of the country’s Ministry of Health, implementing malaria prevention and control interventions in the western, coastal and Rift Valley regions, including in Lydia’s village.
The society’s malaria work builds on lessons learned from the home management of malaria intervention that was implemented in over 100 difficult to access villages in Kenya’s coastal region. Community case management of malaria has now become a pillar in extending the reach of the health system in the country and is fully embedded in the National Malaria Strategy for 2009 – 2017, which aims to ensure that, by 2016, all patients with malaria receive treatment.
The strategy addresses the challenges of delivering timely and effective treatment and improves access. Communities are often discouraged from seeking treatment at health facilities due to long distances, the cost of transportation and care, and time spent at facilities.
Trained community health workers and volunteers facilitate access to malaria prevention, diagnosis and treatment services. They trace cases in communities, test for malaria and administer life-saving treatment.
Lydia says malaria has been a problem in the village for some time. “Since the community health workers and volunteers started testing and treating us at home, we’ve been relieved of the burden of walking to the dispensary which is about 4.5 kilometres away,” she says. “It also means we receive medical care from someone we not only know as part of our community, but someone who is also trusted by my family.”
The community health worker concludes the tests and confirms that Nekesa has malaria. He prescribes the treatment and demonstrates how to administer it.
“The community health worker advised me to ensure that my family sleeps under insecticide-treated mosquito nets as he recently demonstrated to us. I will do so and spread the message of the good work being done by community health workers,” Lydia says. She will also spread the message to other mothers in the community.
Accurate diagnosis has significantly improved the quality of care and ensured that antimalarial medicines are used correctly. Since the inception of the project, nearly 4,500 people diagnosed with malaria have received treatment from community health workers. Through community structures, the Kenya Red Cross Society has made great strides in ensuring early testing and treatment of uncomplicated malaria using rapid diagnostic kits. In total, the project has trained more than 1,150 community health workers and volunteers on community case management of malaria. These have been instrumental in identifying, testing and treating malaria at home while referring sever cases to health facilities.