Malaria is the leading cause of morbidity and mortality in Kenya.
25 million out of a population of 44 million Kenyans are at risk of malaria.
It accounts for 30-50% of all outpatient attendance and 20% of all admissions to health facilities.
170 million estimated working days are lost to malaria each year (MOH, 2001).
Malaria is also estimated to cause 20% of all deaths in children under the age of 5 years (MOH, 2006).
The most vulnerable group to malaria infections are pregnant women and children under the age of 5 years.
The government in collaboration with other partners has developed the 10-year Kenyan National Malaria Strategy (KNMS) 2001-2010 (link) which was launched in April 2001. Its goal is to reduce morbidity and mortality associated with malaria by 30% by 2006 and to maintain it up to 2010.
This approach deals with the formulation and implementation of malaria treatment policy issues.
2. Management of malaria and anaemia in pregnancy
This approach addresses the provision of malaria prevention measures and treatment of pregnant women.
3. Vector control
This approach ensures that the risk communities use insecticide treated mosquito nets to significantly reduce rates of the disease and other methods through Integrated Vector Management.
4. Epidemic Preparedness and Response (EPR)
This approach improves epidemic preparedness and response by establishing malaria early warning systems and carrying out preventive measures such as the Indoor Residue Spraying (IRS) campaigns.
In addition to the four strategic approaches, the NMS outlines two vital cross cutting strategies required to support the above strategic approaches, namely:
Information Education Communication (IEC): This strategy is meant to create awareness to the public regarding malaria preventive and treatment. It is also intended to inform all partners involved so that there is uniformity in the messages disseminated to the communities.
Monitoring and Evaluation (M&E):M&E and operational research are used to provide reliable information on progress in controlling malaria.
The level of malaria endemicity in Kenya varies from region to region and there is a huge risk diversity of malaria infection. This is driven by climate conditions such as temperature and altitude. Kenyan counties are categorised into five classes of ecology based on malaria infection risk. They include:
1. Lakeside endemic areas
These are counties close to Lake Victoria where transmission is throughout the year.
2. Coastal endemic areas
These are counties with similar characteristics as the lakeshore in endemicity. However, malaria transmission and risks periods are seasonal and transmission intensity is lower toward the Somali border.
3. Highlands endemic areas
The prevalence of malaria parasite is low in these areas. There is always probability of malaria transmission and risk in this region but it is generally low on an average year. However, rainfall and ambient temperature variations in between the year can lead to epidemics thus affecting community members.
4. Arid seasonal areas
These are counties in the north eastern and western regions. Malaria is experienced only in communities that live near water bodies. These regions experience low rainfall during the year thus the malaria transmission parasites are few and there is low infection prevalence rates in children.
5. Low malaria risk areas
These are highlands within Central and Nairobi area. Some areas do not experience any malaria transmission risks such as Nyeri, Nairobi and Nakuru.
NMCP, previously Division of Malaria Control (DOMC) with support from various partners has been monitoring the burden of malaria through various channels. They include; health information data from hospitals and clinics, sentinel sites surveys of communities and health facilities in 4 districts and national surveys including the Kenya Demographic Health Survey (KDHS).
Evidence from these sources shows that there is increased coverage of interventions, low reported cases of malaria burden demonstrated by communities, low hospital admissions and deaths. This is approximately 44% reduction in childhood mortality.
Increased malaria control interventions such as the distribution of ITNs enabled revision of declining health trends in the country between 2002 – 2007.
In 2006, there was mass distribution of LLITNs in 47 counties. Others were distributed through clinics and social marketing.
The graphs below shows some other achievements.
Source: HMIS and DOMU Routine data from Health Management Information System and the weekly reports from Disease Outbreak Management Unit shows a gradual decrease in malaria cases in the country.
Implementation of the National Malaria Strategy is organised by the Ministry of Health and coordinated by the NMCP. There are various partners involved in increasing malaria control interventions including the private sector, NGOs/FBOs, bilateral and multilateral partners.
The Malaria programme has received tremendous technical and financial support from WHO, MSH, UNICEF, the KEMRI/Welcome Trust Programme, DFID, PSI, RBM, USAID/PMI and other partners.