Community Health Volunteers Battle Malaria in Southwestern Madagascar

Fanamamy Retsilaky receives a prize from the Ministry of Public Health for his contribution to the fight against malaria.Photo Credit: Samy Rakotoniaina.

Madagascar has seen a strong upsurge in malaria cases over the past two years, particularly in the southwest, despite the Ministry of Public Health (MOPH)’s eradication efforts. Malaria-carrying mosquitoes seem almost invincible despite the use of insecticide-treated bed nets and indoor spraying. As a result, communities have become more engaged in prevention activities in order to protect themselves from the deadly disease.

Fanamamy Retsilaky helps fight malaria in the Ankililoaka commune. As a community health volunteer (CHV) in the Fokontany of Amboboka, he benefited from malaria trainings and refresher courses on the integrated management of childhood illnesses provided by the USAID Mikolo Project between 2014 and 2016. He regularly sees children presenting with fevers in his health hut, where he performs a rapid diagnostic test to confirm malaria infection. Retsilaky has already tested over 2,100 cases of fever since 2014, with 1,672 confirmed cases of simple malaria.

"Our fokontany is surrounded by rice fields and becomes isolated and almost inaccessible between November and April, during the rainy season. However, I frequently have stock-outs of ACT (artemisin-based combination therapy)—the cure for malaria–-and I must order more from the basic health center,” he said. As a result of Retsilaky’s persistence in ensuring an adequate supply of ACT, he has been able to treat children who test malaria-positive. 

Another challenge in the fight against malaria is the widespread use of traditional medicine in the southwest. Parents usually go to the local healer first and only visit CHVs after their children’s health has deteriorated. "Recently, there was a sick child from another Fokontany who was introduced to me. I referred him directly to the health center but he died upon arrival because the parents still used traditional medicine and waited too long before seeing me,” Retsilaky said.

Such incidents have inspired him to intensify his community sensitization efforts. In addition to diagnosis and treatment, Retsilaky continues to raise awareness in his community about the importance of consistent and proper use of bed nets and of visiting a CHV once a child starts exhibiting symptoms of malaria.

Retsilaky’s outstanding and tireless efforts to prevent and treat childhood malaria in his commune prompted recognition by the MOPH. On Malaria Day he received an official invitation from the Minister of Public Health to travel to Antananarivo for trainings and to be the headliner during the next National Community Health Day.

The USAID Mikolo Project and the MOPH’s malaria control department continue to work together to strengthen epidemiological surveillance at the community level, as well as enforce seasonal prevention and treatment campaigns in malaria-endemic communes, such as Ankililoaka. These activities, combined with those of CHVs like Retsilaky, will hopefully help to eradicate malaria from Madagascar.