Reducing malaria in Cameroon by improving monitoring and evaluation systems

Malaria is a deadly disease that affects millions of children in Cameroon. To help, Cameroon joined nine other countries in adopting a strategy called Seasonal Malaria Chemoprevention (SMC), which provided anti-malarial drugs to children under five years during the peak transmission seasons from 2016-2021. ICF’s malaria experts worked with local officials to gather and use routine data on malaria cases and rainfall to better target SMC programs. A new study found that SMC reduced both uncomplicated and severe malaria in young children in Cameroon thanks to the program’s work.

Challenge

Malaria is responsible for nearly 60% of deaths among children under five years in the North and Far North regions of Cameroon, where there is a high seasonal malaria transmission—that is, where most malaria cases occur during a few months of the year. To protect children from malaria during its high season, The National Malaria Control Program introduced SMC in 2016. SMC consists of giving a maximum of four monthly doses of anti-malarial drugs to children aged three months to just under five years in areas with high seasonal malaria transmission.

Despite six years of SMC implementation and an overall reduction in the malaria burden, it still remained high in both regions, representing 37% of the national malaria confirmed cases and 60% of the national malaria deaths among children under five, and no study had systematically assessed and documented the effects of SMC in Cameroon using routine data collected by health facilities and reported through the Health Monitoring Information System (HMIS).

Solution

The PMI-funded Measure Malaria project worked across 10 countries to streamline the national malaria surveillance, monitoring, and evaluation system to generate quality data for program effectiveness. ICF supported the National Malaria Control Program’s implementation of the SMC in eight of those countries and drove the measurement of project results in Cameroon specifically.

At first, SMC was difficult to track due to a lack of accurate information and dispersed data. A good data system was needed, quickly. In Cameroon, we worked with local officials to establish ways to streamline information between communities, health facilities, and public health officials. We then established pilot sites in health facilities to collect information systematically to generate high-quality data. Thanks to our team’s combined data, program implementation, global health, and malaria-specific expertise, we were able to fuel more complex analyses more quickly to better target resources.

Results

A peer-reviewed study conducted by ICF and local partners found that SMC in the North and Far North regions of Cameroon led to a noticeable reduction in malaria cases during the seasonal high-transmission periods of the program’s duration from 2016 to 2019. The reduction ranged from 10% to 15%, with the highest reduction in 2017, when we saw a 15% decrease in uncomplicated malaria cases and a 51% reduction in severe malaria cases—a significant achievement given that between 2011 and 2015, before intervention, malaria cases doubled.

The study recommended further implementing SMC to reduce the malaria burden in Cameroon. Gaps in evidence and information are common with public health challenges, but an experienced partner can make all the difference in both data collection and outcomes.