Abt Associates: Bold thinkers driving real-world impact
In Zambia, a systemic attack against malaria is underway. Working closely with the National Malaria Control Center in support of the Ministry of Health, the Zambia Integrated Systems Strengthening Project, known as ZISSP, is deploying doctors, entomologists, and other experts to target, track, and control mosquitoes that carry the dangerous disease.
Malaria is one of the biggest killers of children under five in Zambia. Abt Associates, known for its expertise in strengthening health systems worldwide, is implementing ZISSP, which is funded by USAID.
Indoor Residual Spraying Brings Relief
According to Dr. Peter Mumba, the malaria team leader for the project, one of the cornerstones of the malaria control effort is indoor residual spraying, or IRS, in which homes are sprayed with pesticides to repel mosquitoes. The pesticides are approved by the World Health Organization and are harmless to humans.
The project recruits hundreds of sprayers to go to homes in rural and poor urban areas and carefully apply the insecticide to the walls and along the roof line. The spraying takes place in October and November, just before the rainy season when mosquitoes proliferate.
Prior to spraying, trained “enumerators” visit households in each of the targeted districts to explain IRS and gather information about home and family. The data for each household includes the number of children under five in the home and the number of rooms and separate sleeping spaces and is entered on handheld personal digital assistants or PDAs.
“The PDA is good because you can collect a lot of information in a short time, and it’s easy to transfer the information to a computer,” said Bernard Sichamba, a local enumerator who conducts interviews in multiple languages.
Multi-Pronged Effort Involves Research, Planning, Training
Marguerite Mwale lives in Chipulukusu, a poor community in Ndola district whose 68,000 residents live in small, mud brick huts where candles provide the only light. The incidence of malaria in Chipulukusu is one of the highest in Ndola district. Holding her seven-month-old granddaughter, Priska Sandonge, on her lap, she said her home was sprayed last year.
“When the houses were sprayed, malaria was drastically down,” she said. As an indication of just how prevalent malaria is, she revealed that the child she held was being treated for it.
Dr. Mumba noted that in last year’s spraying in Chipulukusu they found that several types of mosquitoes had become resistant to the insecticide applied there, a constant challenge.
That problem is being tackled by Mulenga Musapa, one of less than 10 entomologists in Zambia working on malaria, and a key member of the ZISSP team. He traps mosquitoes in homes to be sprayed and studies them to determine their resistance to different types of insecticides.
“The information we have will help a lot in choosing insecticides and in monitoring trends in mosquito resistance to insecticides for the coming years,” said Musapa.
Abt’s ZISSP staff works side by side with the Ministry of Health and health officers at the national, provincial, and district levels to strengthen skills and systems for planning, management and delivery of high-impact health services. ZISSP also works with communities to promote increased use of public health services.
In addition to fighting malaria, ZISSP is working with the Ministry to increase utilization of public health interventions in the areas of HIV/AIDS; family planning; maternal, newborn and child health; and nutrition. Building sustainable capacity in all these areas is a critical part of the project.
“Every year, more health workers are trained in various parts of the malaria-control program along with community health volunteers,” said Dr. Mumba.
Abt Associates is a mission-driven, global leader in research, evaluation and program implementation in the fields of health, social and environmental policy, and international development. Known for its rigorous approach to solving complex challenges, Abt Associates is regularly ranked as one of the top 20 global research firms and one of the top 40 international development innovators. The company has multiple offices in the U.S. and program offices in more than 40 countries.