Anti-malaria efforts focus on pregnant women, children

Health authorities are successfully battling malaria in remote eastern Indonesia by linking efforts to fight the mosquito-borne disease to maternal and child healthcare.



"Pregnant women and children are especially vulnerable to malaria, and modern malaria diagnosis and prevention can be delivered via existing maternal health and immunisation services in a symbiotic way," said William Hawley, a malaria expert with the UN Children's Fund (UNICEF).



Nurses and midwives help the malaria programme with diagnosis, treatment and bed net distribution, Hawley said. Furthermore, because people want bed nets, more women use antenatal care and bring their children to be immunised.



"The malaria programme, the antenatal care programme, and the expanded programme on immunisation all benefit, but most important - women and kids benefit," Hawley said.



Malaria was once the top health problem in South Halmahera District - 400 islets inhabited by 200,000 people in North Maluku Province, health officials say.



Swamps, poor sanitation, poverty and low levels of immunisation left the population - pregnant women and children in particular - vulnerable to health problems.



By integrating prevention, diagnosis and treatment with antenatal care and child immunisation, the number of malaria deaths in South Halmahera plummeted from 226 in 2003 to four in 2008, and the incidence of malaria dropped by 50 percent, according to the district health office.














Photo: Swiss Radio
Malaria was once the top health problem in South Halmahera District

Hawley said neighbouring districts in the Maluku Islands are trying to replicate South Halmahera's success, and similar anti-malaria efforts are under way in several other districts in Indonesia.



Free treatment



The head of South Halmahera District, Muhammad Kasuba, stepped up the anti-malaria programme three years ago.



"We have to scrub out this disease altogether, so we can start developing our infrastructure," said Kasuba, who has provided his district with universal healthcare since 2007 to ensure the community receives free malaria treatment as well as other basic health services.



Residents were also taught to prevent mosquito breeding by turning over boats filled with water and digging channels from the sea to lagoons to keep them too salty for mosquitoes, while children learned how to differentiate between malaria mosquitoes and other types.



Authorities also set up the South Halmahera Malaria Centre as a hub for training and coordination.



About half of Indonesians - 158 million of the country's 230 million people - are at risk of malaria infection, according to the University of Oxford's Malaria Atlas Project (MAP) and the Ministry of Health.



In 2008, there were 411,979 malaria cases confirmed by lab tests, though an additional 863,213 were tallied as probable cases, according to the World Health Organization (WHO). It reported that 2.15 million insecticide-treated bed nets were distributed between 2004 and 2008, enough to cover six million people living at high risk of malaria.



Elsewhere in Indonesia, local health authorities, supported by WHO and Care International, implemented anti-malaria efforts after the devastating tsunami in Aceh in December 2004.



The island district of Sabang, off the coast of Banda Aceh, had a 4.3 percent malaria prevalence in 2005. That dropped to less than 1 percent prevalence rate in 2009, said Hawley.



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