Situation Analysis on Malaria Control in the Context of Ongoing Health Sector Reforms in Rufiji District 2002

A cross-sectional situation analysis of malaria control activities was conducted in Rufiji District along Coastal Tanzania. Three divisions out of six were covered. The study involved four study populations comprising of Health care providers, District leaders including community PHC members and village leaders, community members and a retrospective analysis of in-patient records. The main objective was to assess the performance of malaria control activities. Specifically coverage / promotion of Insecticide Treated Nets, Malaria case management and knowledge, practices of health care providers including the community was assessed. In addition, the district health plan was reviewed to ascertain whether the goals and targets were evidence based. The District health plan was explicit about malaria as a public health problem and clearly defined its implementation strategies and targets. However, in practice, malaria control was greatly deficient. The ITNs coverage is below 20%, malaria case management is variable depending on availability of facilities, knowledge about malaria control arriongst health staff is lacking and not uniform. Knowledge of the population about malaria is also flawed and their participation is questionable. This is reflected by 30% of the community respondents still seek traditional healers to treat their febrile children. Poverty was identified as a major constraint. The results of the situation analysis are discussed in the light of these constraints. Recommendations are suggested for the district as well the central Governmen