#ZeroMalaria: Best practices from Rwanda, Tanzania

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The African Union did not achieve the goal of reducing malaria incidence and mortality by 40% by 2020, a key milestone to eliminating malaria in Africa by 2030.Instead, between 2015-2020, malaria incidence declined by 1%.
According to WHO estimates, 96% of global malaria cases and 98% of malaria deaths occur on this continent. In 2020, 611,802 Africans died from this disease of which 80% were children under the age of 5. Furthermore, revised estimates by the WHO in the 2021World Malaria Report indicate that the number of malaria deaths was previously underestimated and the burden is worse than previously understood.

In the 2020 Decision on the Report on Malaria, the African Union called on Member States to “use national malaria scorecards, action trackers and engage stakeholders to align their activities with these tools at all levels to enhance accountability, transparency and action.”
National malaria scorecards and action trackers are effective management tools that support a systematic and evidence-based approach to monitoring national priorities, identifying performance gaps, and taking timely corrective action to enhance impact.

Best practices by Member States in 2021

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Rwanda: has made significant progress in institutionalising its integrated malaria/neglected tropical diseases (NTDs)scorecard and reproductive, maternal, newborn, child and adolescent health (RMNCAH) scorecard. These scorecards are included in national strategic plans as key performance and management tools and are published publicly.
The scorecards are used for routine supervisions and to facilitate bottleneck analysis and action, even at the community and health-facility levels. For example, an increase in malaria cases on the malaria/NTD scorecard prompted a decision to reallocate commodities to health centres with high numbers of cases.
Zambia: uses its malaria scorecard and workplan to track progress at national and subnational levels. The use of the workplan increased the timeliness implementation of planned activities. Zambia also uses the malaria scorecard to report to national and provincial End Malaria Councils so they can act when new gaps are identified.

Tanzania: trained 90 parliamentarians on how to use the national malaria scorecard to assess the malaria situation within their constituencies and support timely actions. A mobile application was launched to enable parliamentarians to access the scorecard and action plans from their personal devices.
Ghana: incorporated routine, community-generated feedback into the national health management information system, enabling the production of scorecards for a broader set of stakeholders across the country. Ghana mobilized $3.2 million USD from the French government to scale up the use of scorecards and train the media to disseminate data and drive accountability.
The Republic of Mali: used its scorecard to monitor essential services during the disruptions due to COVID-19. During Q1 2021, the division for Planning and Statistics, relevant ministry programs and partners reviewed the impact of COVID-19 on RMNCAH services. Each month, a technical working group reviewed the barriers to accessing services and any gaps in the continuum of care across the country. Findings were then shared with the Ministry of Health’s cabinet to drive strategic decision-making and implementation of pandemic response policies.

Kenya’s RMNCAH scorecard is decentralized to the county level and shared with key county stakeholders including politicians and technical teams. The digital scorecard includes data descending all the way down to health facility level, making it possible to identify and resolve issues in a targeted way.

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