Background

The Eswatini malaria scorecard was first produced in 2015 and has been updated regularly. The Eswatini Malaria Elimination scorecard tracks 8 malaria indicators which include:

• cases notified within 24 hours
• uncomplicated cases treated according to national guidelines
• severe cases treated according to national guidelines
• local cases
• imported cases
• total deaths
• cases investigated within 48 hours
• % of structures sprayed (IRS)

How it works

Between 2015 and 2019 the malaria scorecard was produced bi-annually by the NMCP and shared with the Minister of Health. Since 2019 the scorecard is now being produced quarterly and in addition to being shared with the Minister, senior management in the ministry and other stakeholders, it is also now being shared with members of the End Malaria Fund and was shared during the launch of the Eswatini Malaria strategic plan and official opening by the Prime Minister of the End Malaria Fund Offices.

Impact

Resource mobilisation

His Majesty the King of Eswatini established and launched the End Malaria Fund. This fund exists to mobilise the resources necessary to close the funding gap and ensure that we eliminate malaria by 2022, and then prevent the reintroduction of malaria thereafter. This fund is a public-private partnership composed of representatives of the public and private sectors, as well as representatives of communities. The scorecard is shared with members of the End Malaria Fund members. The Fund has supported malaria control with additional support to finance gaps in malaria surveillance and indoor residual spraying.

Service delivery improvements

On review of the malaria scorecard, it was noted that the performances of the investigation of all malaria cases within 48 hours, notification of all cases within 24 hours and IRS coverage were observed to be low in some localities. The NMCP carried out an analysis of the possible challenges noted in the scorecard and identified the causes were:

• there was disruption of services in mobile numbers used for the 977 Immediate Disease Notification System which was used in the notification of malaria cases
• there were changes in the transport management system which affected availability of transport for use for purposes of case investigation and IRS campaigns

The challenges in the immediate notification system were addressed, by advocating to the CEO of the MTN service provider to successfully advocate for the system to be restored. This resulted in MTN reactivating the notification system with a one-year commitment to provide the system in-kind. Additional support and funding were provided to the transport management system to improve case investigation for the IRS campaigns.

Key success factors

• Availability of data and consistent production of the scorecard
• Sharing of the scorecard with Ministry of Health management and other stakeholders including Chiefs created great awareness and engagement around malaria

Partners engaged in supporting the scorecard

• World Health Organization (WHO)
• End Malaria Fund
• Clinton Health Access Initiative (CHAI)