Malaria in drc

According to the World Health Organization’s World Malaria Report for 2019, an estimated 228 million cases of malaria occurred and 405,000 deaths globally in 2018. DRC accounted for 12 percent of these cases and 11 percent of deaths, making it the second-most affected country in the world. The benefits of reducing malaria go beyond the obvious outcomes of reducing sickness and death. The report also states that “A 10 percent reduction in malaria has been associated with a 0.3 percent rise in annual GDP. At the household level, reducing malaria protects household income from lost earnings.”

IMA DRC has been working to bring these benefits to millions in the DRC for over two decades. During the Access to Primary Health Care Project, IMA and its partners distributed close to 1.3 million nets in Kasai and Nord Ubangi provinces. To ensure that every household received the intended nets, IMA devised a Hang Up and Track or HUT campaign in which community health workers distributed the LLINs, installed them in each household and recorded household registration data using smartphones to ensure accountability and accuracy.

The innovative HUT approach has been found to promote higher net-use rates than traditional methods, in addition to giving an unprecedented level of transparency and accountability to net distributions.

Implementation Period

NMF Phase 2 – December 2018 to June 2021

NMF Phase 3 – July 2021 to December 2023

Project Cost

NMF Phase 2 – $21.4 million

NMF Phase 3 – $22 million

Donor

The Global Fund

ABC – A New Approach to Contracting

Under a traditional mass distribution of LLINs approach by the Global Fund, funding was conditioned upon compliant procurement and financial management. This led principal and sub-recipients to focus on ensuring documentation compliance to the point of delayed distributions and the diversion of programmatic resources away from overseeing campaign delivery and data quality. In this setting, delays of 3 to 5 months have been experienced due to delays in procurement of transport contracts from Health Zones to Health Areas. Further, the documentation generated by Health Zones has historically exhibited irregularities and inconsistencies.

The shift to implementing Activity Based-Contracting (ABC) places funding eligibility on programmatic deliverables critical to a quality distribution campaign. IMA establishes these contracts with each health zone, using three deliverables: 1) the number of households covered with the assigned number of long-lasting insecticide-treated nets (LLINs); 2) The workforce trained to carry out distribution activities in each health zone; 3) The number of LLINs accounted for following campaigns (the total LLINs delivered to a Health Zones – (the number of LLINs delivered + the number of left over LLINs returned to the prime)).

Procurement and expenditure documentation is therefore not collected at the health zone level, removing the delay associated with their collection and allowing programmatic resources from IMA to be devoted to distribution oversight and quality campaign planning, delivery, and data. These three deliverables are then independently verified and agreed upon by all stakeholders, after which IMA provides payment per health zone based on verification adjustments.

By moving to an ABC approach, mass campaign distribution time was reduced from 9 – 10 months to 4 – 5 months, while maintaining high net coverage. 

read more about our work combat malaria through our hang up strategy