Table 4 Matabeleland North Year 1 challenges

Regular review of malaria case investigation data and data management

Identify focal persons to be point of contact and follow up for surveillance related work, provide mentoring and supportive supervision visits on how to use DHIS2 tracker (malaria elimination surveillance system) to the focal persons, regular onsite data verification and data cleaning, initiation of regular surveillance meetings

8% increase in malaria slide examination rates of confirmed cases (81% to 89% or 115/142 to 90/101 slides examined out of total positive cases)

10% increase in fully investigated cases (88% to 98% or 125 cases investigated out of 142 RDT + cases to 99/101)

Weekly disease surveillance reports shared with province: 1 out of 5 districts; quarterly district review meetings conducted: 2 out of 5 districts; quarterly provincial meetings conducted: 2

Improvements to data discrepancies and timeliness (no quantitative data available to support)

Implementation of new treatment guidelines

Mentoring of health workers and VHWs, refresher trainings, setting up a help line

12% increase in the administration of primaquine (63% to 75% or 90/142 to 76/101 cases administered PQ/total positive cases)

Refresher trainings ongoing but all five eliminating districts have conducted post-training follow-up visits and VHWs now trained

Coordination across departments

Map stakeholders, attend district and provincial social services and local governance meetings, develop service improvement plan

Target achieved at district level for external coordination. See Box 2. Improvements to internal coordination were in progress

Lack of ownership and accountability

Conduct team building, award best performing district, provide peer support visits

Peer support visits implemented in 2 of 5 districts. Other activities were in progress

Malaria commodity stockouts

Create reporting template for tracer commodities, supportive supervision visits to improve stock management, redistributing excess commodities to other districts, supply VHWs with essential commodities

20% improvement in medicine stock status (50% to 70%)

Larval source management

Order biolarvicide, map active breeding sites, train environmental health practitioners in LSM, use standardized bio larviciding reporting form

1 of 5 districts have completed mapping. Training in 2 of 5 districts conducted

Poor quality IEC materials, unknown effectiveness of SBCC activities

Identify translators and correct malaria messages, evaluate impact of activities

Work in progress