Combatting Malaria

ACCELERATING CHILD SURVIVAL AND DEVELOPMENT 2009 Uganda’s Battle Against the Top Childhood Threats © UNICEF Uganda/2008/Chulho Hyun

CONSOLIDATING MALARIA CONTROL SITUATION SUMMARY Overcoming the deadly impact of malaria continues to be the greatest development challenge affecting Uganda today. The disease is endemic in 95% of the country and is the number one killer of children accounting for more than 32% of deaths of children under five and contributing significantly to miscarriage and low-birth weight of infants. It also the most frequently reported reason for illness among adults and accounts for 50% of all outpatient department attendance and 35% of all in-patient admissions. According to certain estimates, as many as 70,000 to 100,000 deaths can be attributed to malaria every year in Uganda. While MDG 6 directly addresses the need to consolidate malaria control (to arrest and reverse the spread of HIV and Malaria), it is clear no meaningful progress on MDG 4 (to reduce child mortality by two thirds) can be made without tackling this disease. It is also the key to breaking the cycle of extreme poverty that traps over 30% of Ugandans. Some studies show poorer families can spend up to 34% of their income on malaria treatment. Tackling MDG1 (to eradicate extreme poverty) therefore, is also linked to the fight against Malaria. Despite obvious human and financial losses, the 2006 Uganda Demographic and Health Survey (UDHS) estimates that only 16% of households own an Insecticide Treated Net (ITN) and less than 10% of children underfive years sleep under them. In addition, only 10% of pregnant women reported sleeping under an ITN and less than 16% received the proper preventative protocol for malaria during their ante-natal care visit. In terms of treatment, coverage of Home-Based Management of Fever is expanding, but only 29% of children under-five received anti-malarial drugs the same day or next day of a fever.

THE REGIONAL PERSPECTIVE In response to the overwhelming burden of the disease in the Lango sub-region (transmission rates are the UDHS 2006: Key Malaria Control Indicators % of housholds covered

A t Least 1ITN

U5 sleeps under ITN

pro mpt treatment

50 40 30

It would be a great shame to win the war for peace – but lose the battle against child mortality. Above, children in Oyam District in northern Uganda begin their battle against malaria.

highest in the world in Apac District), UNICEF and the Government of Japan distributed over 230,000 ITNs in late 2007, aiming to boost the coverage of households with two ITNs to 70%. In response to the dismal levels of net ownership in the Karamoja sub-region, UNICEF distributed over 340,000 nets in late 2007, aiming to raise coverage of households with two ITNs from 3.4% to all families. Post-distribution surveys will determine the new levels of coverage.

MALARIA CONTROL INDICATIVE BUDGET FOR 2009 UNICEF works at the national level and in 23 focus districts to ensure that all children are protected against malaria by: • Supporting the Government’s policy to massively scale up distribution of ITNs to the level of two nets in every household. In 2009 control efforts will aim to scaling up net coverage in Western Uganda from 3.3% (UDHS 2006) of households with more than 2 ITNs to 80% with 2 ITNs. • Using Village Health Teams (VHTs), local councils, faith-based institutions, and radios to promote the use of ITNs in all 23 districts; • Supporting the training and equipping of VHTs to deliver Community Case Management for malaria using the new Artemisinin Combined Therapy (ACT) in 10 districts. Budgetary Requirements: 9.3 million USD • 7 million procurement & distribution of 1million nets; • 2 million for promotion of proper use in 23 districts; • 300,000 to support VHTs for prevention and proper treatment of malaria.

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FOR MORE INFORMATION

0 IDPs AcholiLango

Karamoja

Western

Dr. Claudia Hudspeth Chief, Child Survival [email protected]

Karen Allen Deputy Representative [email protected]