Rwanda Community-based management of malaria

Photo: Health worker, boy, sibling

In late 2016, Rwanda opened community-based treatment of malaria to also include children over 5 years and adults; the government also granted free malaria diagnosis and treatment to the most economically vulnerable populations. [1]

Community case management is provided by CHWs through complementary programmes of integrated community case management (iCCM) and home-based management of malaria (HBM). With expansion of community management of malaria, by early 2017, 56% of all malaria diagnosis and treatment in Rwanda was done by community health workers (CHWs). [1]  The countrywide cadre of 45,000 CHWs is being expanded to 60,0000 with 2 CHWs per village focused on delivering iCCM and providing diagnosis and testing of malaria for persons of all ages in the community. [1] The MOPDD introduced a new rapid, short message service (SMS) system in late 2018 to coordinate the referral of severe case cases from CHWs to health facilities. [1]

iCCM refers to the integrated approach for diseases (including malaria, diarrhea, and pneumonia) among children aged 5 years or less while HBM is for the management of only malaria in community among children aged more than 5 years and adults. [1]

In 2019, the MOPDD was considering rectal artesunate for pre-referral intervention for severe malaria at the community level while pending transfer of the patient to health facility; there were concerns about cost effectiveness, however, with decreasing numbers of severe cases, particularly among children under five. [1]