Angelika (center) with facilitators and training aids for health workers in Namibia

“I thought the war on malaria would never end” said Angelika Kanguro, who has been nurse in Namibia’s Northern Region of Kavango for over 27 years. When she was growing up malaria was the number 1 killer in the region. Experienced nurses like Angelika are used to treating every fever case as malaria, especially in young children, in order to save lives.

However, over the last 12 years, with malaria control efforts including nets, spraying, rapid diagnostics and effective treatment, Namibia has seen a remarkable decline in malaria cases and deaths of over 95%. It is no longer the case that the majority of fever inducing illness is due to malaria. Therefore, better malaria diagnosis and case management of fevers is essential – to ensure that patients get the right treatment.

We have been working with the Ministry of Health and the Clinton Health Access Initiative to address this issue, designing and testing enhanced training and support for health workers in Kavango. Angelika above, is one of the nurses helping us do this. She is now a district “mobile malaria mentor” following up the initial training with clinic visits to check progress and answer questions. In another Kavango district we are testing whether sending simple SMS texts to health workers to remind them of the key training messages also helps improve performance.

Graph showing the reduction in the number of patients without malaria* who were incorrectly treated with antimalarials (*Testing negative for malaria through a rapid diagnostic test)

We listened to nurses in how to design the training to meet their needs and this seems to be yielding results. The clinic data is now in for the first three months of implementation and it is very encouraging. It shows an increase in the percentage of cases tested for malaria and, most importantly, a major reduction in the number of non-malaria cases treated with malaria drugs. As the graph here shows, this is a very significant improvement on the same period last year.

Angelika herself has had very positive feedback about the training from the nurses that she mentors. She says the benefits include knowing how to use the rapid diagnostic tests properly and also, critically, understanding that malaria has dramatically declined in local communities, and that nurses should not be expecting to see as many malaria cases anymore: “This feedback helped us frame the way we look at cases. Before the training, when a patient would come to the facility with a fever, we would already judge that the patient has malaria, because we thought we were in a high malaria burden area, like the past. But with the evidence shared at the training, we see this is not the case anymore.”

Data collection and analysis is ongoing and we are anticipating full results from this work in January. However, the encouraging results so far have already prompted the Ministry of Health to begin planning for a national roll out of this enhanced training design. With support from the Global Fund to Fight AIDS, TB and Malaria, roll out is now being planned for Spring next year.

Our funding for this programme has been made possible thanks to our partnership with Jack Wills, the support of a number of Trusts and Foundations as well as contributions from donors and fundraisers throughout the UK. Thank you to all for your ongoing support in helping make sure malaria is prevented, diagnosed and treated correctly.

Find out more:
Our work in Namibia
Our partnership with Jack Wills
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