Story By Zeddy Bore and Catherine Otieno AIRS Project-Kenya
For the first time in five years, Indoor Residual Spraying (IRS) was implemented in Kenya. The Presidential Malaria Initiative (PMI) AIRS Project in collaboration with NMCP and Migori county implemented IRS in six sub-counties in Migori County: Awendo, Nyatike, Rongo, Suna East, Suna West and Rongo. The main goal of the campaign was to contribute to the reduction of malaria burden in one of the highly affected Counties in Kenya. This was done through high quality spraying of structures, compliance with environmental regulations, establishment of effective M&E systems and entomological surveillance on a monthly basis.
The program began with a strong planning roadmap that included macro-planning at the national and micro-planning at the County and sub-County levels. A total of 2,270 seasonal workers (48% female and 52% male) were hired in Migori County to support the IRS activities. All hired personnel were subjected to intense training that spanned all focal areas of the program including gender awareness. Community members were sensitized about IRS prior to the campaigns to ensure everyone knew the precautionary measures to take before, during and after their house is sprayed.
During the campaign, supervisors who comprised of the NMCP, County and PMI AIRS staff conducted supportive and intensive supervision to ensure that the spray teams were following instructions and performing spraying as expected. Information was generated through CommCare reporting tools and data reporting tools. Regular meetings were held to discuss the challenges and issues arising as well as discuss ways of resolving them. These formed the basis for continuous improvement on performance.
To determine quality of spray of insecticide on the walls, wall bioassay was conducted within two weeks of spraying using a laboratory-reared, susceptible colony of An. gambiae s.s. Kisumu strain.
In each sub-County, a village with already sprayed houses was identified for wall bioassays. High mortality of laboratory-reared susceptible An. gambiae was observed in all sites for both mud and cement walls. Similarly, 100% mortality was recorded for wild collected adult An. funestus. Results from cone bioassay tests demonstrated high potency of the insecticide used in the IRS program.
By the end of the campaign, a total of 212,029 eligible structures were sprayed where 906,388 people were protected, including 16,932 pregnant women and 127,157 children below five years of age. This translated to 97.7 % spray coverage of the total 217,100 structures found.
Roseline Akeyo doesn't know her age...maybe 70. Her grandson is in the background. Roseline takes care of her grandchildren2 and 4 year old because their mother took off and got married elsewhere. She got her house sprayed and she is very glad she made the decision. This is because malaria would make her ill and she wouldn't have the strength to get up and sell fish, while her grandchildren would miss school until she raised transport to take them to see a doctor. She is grateful to USAID/PMI and Ministry of Health for Indoor Residual Spraying (IRS). This is the second time her house is getting sprayed. The last time this was done was about five years ago and she has retained the IRS card that was used at that time. Roseline says that this year the spray operator used a concentrated stronger insecticide and she says the mosquitoes are now gone and they are all able to sleep peacefully. She has two nets which are very old and hopes she would be issued with a new one soon. Wath Onger Operational site. Nyatike Sub County