Transcript Guidelines - Roll Back Malaria

RBM Working Group for
Malaria in Pregnancy (MIP)
Juliana Yartey
Chair, RBM MIP
Department of Making Pregnancy Safer
WHO, Geneva
12th RBM Board Meeting
10 |-11
May
2007,
12th RBM
Board
Meeting, Geneva
Geneva | 10-11 May 2007
Background
 2001 - Informal Working Group Established
(Convened by USAID)
 2003 – Working Group formalized by RBM and TOR
developed in support of the RBM partnership strategic
plan for "going to scale" with key interventions targeted
to pregnant women at risk of malaria.
 2007 – TOR reviewed and revised to align with
recommendations of RBM Change initiative
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Terms of Reference (TOR)
 Generate consensus on key strategic issues related to MIP implementation.
 Identify critical strategic and programmatic issues and gaps for follow up action by
MIP Partners and other RBM groups.
 Synthesize experiences and disseminate best practices related to MIP
implementation.
 Advocate for increased attention and resources for MIP (MAWG)
 Develop mechanisms for tracking progress of MIP interventions in countries (MERG)
 Assist to coordinate partner resources for MIP (through HWG)
 Foster collaboration between malaria and reproductive health programs at all
levels and promote the development of strategic partnerships at the country level.
 Disseminate relevant information to all MIP partners and other RBM WGs.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Rationale
 Pregnant women are main adult target group affected by
malaria.
 Consequences include fetal loss/abortion, low birth weight,
maternal anemia and death.
 Recent studies: malaria infection during pregnancy is
associated with an increased risk of i) infant anemia; ii)
malaria infection during infancy; and iii) infant death.
 Prevention and treatment of MIP is critical to child survival
and achievement of RBM Goals and MDGs.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
WHO Strategy for MIP
 3-pronged Strategy
– Intermittent preventive treatment (IPT) by DOT
– Use of insecticide treated nets (ITNs/LLINs);
– Effective case management
 Interventions to be delivered through antenatal clinics.
 Requires strong collaboration between malaria and
reproductive health programs and partners at all levels.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Purpose of MIP Working Group
 Generates consensus among Partners on key
strategic issues and best practices for ensuring the
effective delivery and scale-up of interventions for
the prevention and control of malaria during
pregnancy in order to achieve RBM targets and
MDGs.
 Members: Malaria and Reproductive Health
Partners and country program representatives.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Achievements (I)
 Contribution to the development of the WHO/AFRO Strategic
Framework for the Prevention and Control of Malaria during
Pregnancy.
 Supporting the adoption and implementation of the strategy in
countries.
– 32 / 33 countries have adopted IPT
– 19 are implementing at national scale
– 13 are at various stages of implementation
 Development of Monitoring and Evaluation Guidelines for MIP
(in collaboration with MERG)
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Achievements (II)
 Establishment and support for sub-regional MIP Coalitions:
– MIPESA: Malaria in Pregnancy Eastern and Southern Africa
Coalition
– RAOPAG: Réseau d’Afrique de l’Ouest contre le Paludisme
pendant la Grossesse).
– Coalitions are core mechanisms for exchange of experiences
and best practices among countries.
– Countries in MIP networks have developed strong collaboration
among reproductive health and malaria control programs.
– Countries in two networks have gone to scale with MIP
interventions as a direct result of the shared experiences and
implementation best practices.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Status of IPTp adoption and implementation December 06
Implementation
country wide or in all
endemic districts (19)
Small scale
implementation (14)
Not started (1)
Not AFRO or IPT not
recommended.
Data source: Malaria Unit
Map production: ATM division
World Health Organization/AFRO
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Achievements (III)
 Documentation and dissemination of experiences, best
practices and lessons learned from MIP programs
– Documentation in MIPESA countries completed & disseminated
– Documentation of experiences from RAOPAG ongoing.
 Extending experiences from successful RH and malaria
collaboration to HIV/PMTCT programs to strengthen
collaboration among malaria, HIV and reproductive health
programs at the regional, sub-regional and country levels.
 Establishment of MIP Research Consortium (Gates F.)
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Challenges (I)
 Alternate drugs for prevention and treatment in pregnant women
 Missed opportunities for providing MIP interventions in ANC
– High ANC utilization (>70%); low IPT uptake, low ITN/LLIN coverage
 Collaboration between malaria and RH programs at all levels (resource mobilization,
planning, implementation, monitoring and evaluation).
– Involvement of RH in resource mobilization for MIP:
• High resource availability; very little resources dedicated to MIP – mainly for procurement of
drugs and commodities;
• no provision made to support delivery of MIP interventions within ANC;
• no provision made for strengthening RH Services (HR, M&E, Lab, others).
 Support for MIP sub-regional coalitions to sustain their viability and effectiveness as
core mechanisms for RH/Mal collaboration.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Planned Activities/Future Priorities (I)
 Develop and disseminate relevant technical materials and
consensus statements through MIP coalitions and subregional networks.
– Consensus statements and technical updates to provide clarity on
strategic and technical issues related to the implementation and
uptake of MIP interventions (Relevant RBM Partners and WGs):
• Update on the effectiveness of IPT with SP in areas of high resistance to SP
following WHO Technical Consultation in June 2007.
• Technical Brief on IRS and Pregnancy (WIN)
– Document, synthesize and disseminate MIP implementation best
practices (ongoing in RAOPAG countries)
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Planned Activities/Future Priorities (II)
 Disseminate MIP M&E guidelines and standardize
mechanisms for data collection, analysis and
interpretation for M&E purposes across countries
(WHO, MERG, MACEPA).
– Equip MIP Coalitions to provide support to countries to:
• incorporate MIP indicators into their maternal health cards and
registers; and
• establish a common regional understanding and methodology
for data collection and reporting within RH services for
monitoring and evaluation purposes.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Planned Activities/Future Priorities (III)
 Strengthen capacity of MIP coalitions to:
– serve as resource centres for dissemination of MIP materials,
– conduct country-based situation analysis to identify MIP
program implementation bottlenecks,
– provide technical assistance for overcoming MIP bottlenecks
and support scale-up of MIP interventions,
– provide support to GFATM proposal development and other
resource mobilization mechanisms with adequate reflection of
MIP issues,
– foster collaboration between Malaria and RH (HIV) programs,
– advocate for increased attention and resources for MIP.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Planned Activities/Future Priorities (IV)
 Extend support to other geographical regions, particularly
Latin America, Asia and the Pacific regions who have
initiated efforts to intensify the control of MIP and are
requesting support from partners.
 Initiate development of Global Strategy for malaria in
pregnancy which will highlight the epidemiology and
burden of MIP in all regions and current WHO
recommendations for prevention and control in various
epidemiologic situations (In collaboration with WHO).
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Thank You!
| 12th RBM Board Meeting, Geneva | 10-11 May 2007
Proposed Board Actions
 Endorse TOR for MIP
 Determine that MIP networks (MIPESA and RAOPAG) are core
structures and mechanisms for engaging countries directly in
MIP activities and should be supported by the RBM Partnership
Secretariat and funded through Partnership resources
 Endorse the role of MIP Networks and prioritization of their
activities.
 Confirm Board support for the funding of MIP Networks
(RAOPAG/MIPESA) and their activities through the RBM Partnership
Secretariat.
 Approve MIP workplan for 2007-2008.
| 12th RBM Board Meeting, Geneva | 10-11 May 2007