Central African Republic

The MENTOR Initiative’s Malaria Control Response

The MENTOR Initiative began its emergency operations in February 2008 under United Nations Foundatation funding in the north west CAR in the prefectures of Ouham and Ouham Pendé, two of the most dangerous areas and the most populated prefectures. These areas were selected as starting points for emergency malaria control activities based on several key factors that indicated the high risk for severe malaria morbidity and mortality: the north west of CAR is hyperendemic for malaria; the very large population of IDPs, some 24000 in Ouham and 50000 in Ouham Pendé, are now seeking refuge in the bush under temporary shelter and with greater exposure to malaria carrying mosquitoes; the malaria parasite found is the most severe form - plasmodium falciparum; displacement continues in this region; no form of malaria prevention had been introduced and the population had marginal access to health services. The only health facilities exist at the Medecins Sans Frontières - Holland (MSF-H) / Medecins Sans Frontières - France (MSF-F) supported hospitals and health posts near the major cities of Paoua, Bocaranga and Markounda. It is here that malaria represents over 50% of the medical activity. The absence of a strong national level medical system, the prohibitively high cost to access these limited national facilities, the use of ineffective and unaffordable malaria treatments available on the local market had caused th e loss of countless lives who suffered unable to reach care.

The MENTOR programme was designed to target the most vulnerable, the IDP and host populations, with the aim of reducing children mortality rates as well as protecting pregnant women and their unborn children, from the health impact of untreated malaria. The programme is based on large scale prevention activities - Indoor Residual Spraying (IRS), Insecticide Treated Plastic Sheeting (ITPS), Long Lasting Insecticide Treated Nets (LLINs), Information Education Communication (IEC) to protect the entire population from malaria transmission, and the assurance that all children and pregnant women have access to malaria diagnostic and treatment of quality and of close proximity through supporting to existing health facilities and the development of a network of village based malaria agents.