Central African Republic

The MENTOR Initiative’s Malaria Control Response

The MENTOR Initiative began its emergency operations in February 2008 with funding support from the United Nations Foundation. Emergency operations focused on the North West prefectures of Ouham and Ouham Pendé, two of the most populated prefectures and conflict affected areas. This region has all year round intense plasmodium falciparum malaria transmission, and people suffer six or more malaria infections each year. Around one in every five children dies from malaria before reaching their fifth birthday. When this emergency programme began the prefectures were home to 44,165 internally displaced people (IDPs) in Ouham and 54,057 IDPs in Ouham Pendé. The IDPs live predominantly in temporary shelter in forest areas and generally suffer greater exposure to mosquito bites and life threatening malaria. The population had no access to malaria prevention services and only an estimate 10% had access to health services supported by Medecins Sans Frontières (MSF) in the main towns of Paoua, Bocaranga and Markounda. In these few health facilities malaria is responsible for over 60% of patients seeking treatment. The absence of an effective national health infrastructure in this region has lead the loss of countless lives and encouraged extensive use of ineffective and unaffordable malaria treatments purchased in local markets.
The MENTOR emergency response was designed to respond to the challenges above and to reach the IDP and host populations across this region, with the aim of reducing children mortality rates as well as protecting pregnant women and their unborn children from malaria. The programme has progressively rolled a two prong strategy to ensure access to malaria prevention and treatment services. Initially, whilst security remained very poor and population displacement continued the emergency team conducted a campaign to spray the insides of the shelters and homes of 120,000 people using Indoor Residual Spraying (IRS) to protect them for 6-8 months. For newly displaced families we provided them with Insecticide Treated Plastic Sheeting (ITPS) to ensure both basic shelter and combined vector control. In 2009 the team worked with other groups to ensure the delivery of Long Lasting Insecticide Treated Nets (LLINs) to families previously protected with IRS. Each of these campaigns were accompanied by intensive Information Education Communication (IEC) campaigns across the region to encourage effective use and maintenance of prevention services and to educate and encourage families to seek early and effective quality malaria diagnosis and via a network of community based malaria agents established by MENTOR in parallel with the prevention programmes.