Health

Commodity accountability, personel shortage challenges against malaria elimination in Oyo — Stakeholders

STAKEHOLDERS have expressed concern about malaria commodity accountability, staff attrition, and the need for improved data capture of women given intermittent preventive treatment of malaria in pregnancy in the state’s attempt to eliminate the disease.

Speaking at the Oyo State Malaria Technical Working Group at the Oyo State Ministry of Health Conference Centre, Oyo State Coordinator for the US President’s Malaria Initiative for States (PMI-S), Dr Oluwayemisi Ayandipo, said “a major challenge we found was commodity accountability, especially at the secondary health facilities visited.”

She added, “The number of people tested and confirmed to be positive for malaria is lower compared to the number of artemisinin-based combination (ACTs) drugs that were dispensed.”

“We found that primary healthcare facilities were not documenting severe malaria cases in their outpatient department registers; some were also giving fansidar tablets, a fixed combination of sulfadoxine and pyrimethamine, as malaria prophylaxis to patients.

“The attitude of health workers has been a major challenge; the majority of secondary healthcare facilities don’t do microscopy testing for malaria but rather malaria rapid diagnostic tests (mRDTs); some also use malaria microscopy to confirm malaria rapid mRDT results.”

Dr Ayandipo, however, declared that errors in the detection of malaria with a microscope had reduced from 31 percent in July 2023 to 15 percent in January 2024, and the sensitivity rate for malaria microscopy had improved from 67 percent to 88 percent within the same period.

In a reaction, Mr Mubarak Olowookere of the USAID Global Health Supply Chain Programme—Procurement and Supply Management (GHSC-PSM) project, said data tools to capture women given intermittent preventive treatment of malaria in pregnancy were becoming a challenge.

“At a facility in Ibadan North local government, we discovered over 175 fansidar doses were given to pregnant women looking through the case notes, but they were not indicated in the antenatal clinic register,” he stated.

Mr Tosin Orhorhamreru, the Monitoring and Evaluation and Health Systems Strengthening Advisor for the USAID-PMI-S Project, declared that there was a stockout of mRDTs and adult doses of ACTs in many government-supported health facilities.

“PMI-supported facilities and state-supported health facilities had zero percent and 12 percent stock-out rates for mRDTs, as well as 2 percent and 17 percent stock-out rates for adult doses of ACTs. So, we need to look at what partners are doing that are best practices. Also, procurement needs to be done systematically so that there won’t be stockouts or waste.

“Staff attrition is a challenge, and the focus should be more on first absorbing ad hoc staff that are experienced and have been trained. Availability of reporting tools should be prioritised; facility staff or logisticians don’t need to photocopy tools out of pocket. This could be a moral ground for people to see commodities as a way to recoup some cash.”

Earlier, Permanent Secretary, Oyo State Ministry of Health, Dr Akintunde Ayinde, said the meeting, which had experts in malaria from academia and the private sector, was to cross fertile ideas in a bid to improve malaria services in the state.

According to him, malaria is one of the most common diseases that take people to the hospital, and Oyo State’s malaria prevalence rate of about 20 percent was unacceptable.

Dr Ayinde assured all partners working on malaria interventions of the state government’s continuous support and a conducive environment to operate.

Sade Oguntola