A global leader in malaria control

Findings from Zambia’s 2008 and 2006 malaria indicator surveys (MIS) have provided concrete evidence of the dramatic impact of the country’s ambitious malaria control scale-up efforts. The surveys were conducted by the Ministry of Health, through the National Malaria Control Centre and in collaboration with MACEPA and several other Zambia Roll Back Malaria (RBM) partners.

Zambia 2006 MIS: the first of its kind

The 2006 MIS was the first-ever nationally representative household survey assessing coverage of the key malaria interventions and measuring malaria-related burden. The main purpose of the study was to benchmark the Zambia National Malaria Control Centre’s progress toward achieving the goals set forth in the National Malaria Strategic Plan, focusing on identifying changes in anemia and malaria parasite prevalence rates as well as intervention coverage.

Personal digital assistants (hand-held computers) were used for efficient data entry and were equipped with global positioning system units to allow household listing, second-stage sample selection, and interview data collection in a single visit. The findings from the 2006 MIS indicated that nearly half of the households in Zambia owned an insecticide-treated net (ITN), but much work remained, particularly in improving access to interventions among children under age five years and pregnant women.

Access the 2006 Zambia National Malaria Indicator Survey report.

Zambia 2008 MIS: demonstrating dramatic impact

In May 2008, a second malaria indicator survey was conducted. Zambia’s 2008 MIS was based on a sampling of 4,500 households across the country and was carried out by the Zambia Ministry of Health, the Central Statistical Office, MACEPA, the US President’s Malaria Initiative, the Health Systems and Services Programme, the World Bank, UNICEF, the World Health Organization, and the University of Zambia. The main objectives of this study were:

• To collect up-to-date information, building on the experience of the MIS 2006, on coverage of the core malaria interventions included in the National Malaria Strategic Plan 2006–2010.
• To assess anemia and malaria parasite prevalence rates among young children.
• To assess disparities in malaria intervention coverage and malaria parasite and anemia prevalence among the surveyed population by location and other background characteristics.
• To strengthen the capacity of the National Malaria Control Centre and local agencies involved in order to facilitate the implementation of surveys of this type in the future.

Results from the 2008 MIS demonstrated the dramatic progress Zambia is making in its fight to control malaria. Since 2006, malaria parasite prevalence in children has been reduced by 50%, and moderate to severe anemia has been reduced by more than 60%. More people than ever are sleeping under bednets, and two-thirds of all households are protected by at least one ITN or indoor residual spraying.

Most significant is the proven impact on Zambia’s children: bednet use in children under age five years has risen nearly 70% since 2006, and malaria parasitic prevalence in this same group has been reduced by 50% in only two years. In addition, 88% of pregnant women received one dose of preventative medicine and over 65% received two or more doses. This news came shortly after the release of the 2007 Demographic and Health Survey, which showed a 29% decrease in mortality of children under age five years since 2002, meaning nearly 75,000 lives were saved in five years. These findings indicate that Zambia’s malaria control efforts are having a direct impact on its people, improving health and saving lives.

Access the 2008 Zambia National Malaria Indicator Survey report or fact sheet.

What’s next for Zambia?

Zambia is now implementing the next phase in its malaria control efforts and is working to further reduce the economic and health burden of the disease. The country is in the process of developing its next five-year national strategic plan in light of these findings and is well-positioned to attain eventual elimination of the disease. The RBM Partnership Monitoring and Evaluation Reference Group recommends that the MIS should be conducted every two years, which sets 2010 as the target year for Zambia’s next survey. Subsequent surveys will continue to inform the planning process and provide evidence of impact.

Photo: Hana Bilak.