Grameen Swapna

Bangladesh is one of the malaria endemic countries in Sout Asia, with 26.9 million people living in the endemic districts alone (13/64 districts of Bangladesh). From these, 1.5 million people in 3 districts are at highest risk for malaria. This population is larger than many African nations and even the slightest malarial epidemic outbreak in this densely populated region would cause more deaths than the places where the major portion of funds for malaria are currently distributed (Africa). Malaria is a significant health problem in Bangladesh, ranking third among major infectious diseases causing death. Prevalence of malaria is highly endemic in 13 out of 64 districts in Bangladesh: Khagrachari, Rangamati, Bandarban, Cox’s Bazar, Chittagong, Sylhet, Sunamganj, Moulovibazar, Habiganj, Mymensingh, Netrokona, Sherpur and Kurigram. About 98% of total malaria cases are reported from these districts. The number of malaria endemic sub-districts (upazilas) is 70. The total population at risk is 10.9 million.
In 2007, a total of 59,857 laboratory confirmed cases were reported of which 228 resulted in death. Routine surveillance data shows that the proportion of male and female cases of malaria in Bangladesh is 55% and 45% respectively. The income generating group (>15 years) presents the greatest number of malaria cases. Children and pregnant women also belong to this high risk category. The poor and marginalized populations are also prone to infection and are at an increased risk of fatality. In Bangladesh more than 75% of the total cases are P.falciparum malaria (Malaria Baseline Socioeconomic and Prevalence Survey 2007; M&PDC, BRAC, ICDDR,B)

Program Objectives
• To provide Early Diagnosis and Prompt Treatment (EDPT) with effective treatment for all malaria patients
• To ensure the use of long lasting insecticide treated nets (LLIN) and the treatment/re-treatment of ordinary nets in 80% of households
• To raise community awareness and promote community participation regarding malaria prevention and control
• To strengthen program management capacity, coordination and partnership in malaria control
Program Activities
• Advocacy and community-based Behavioral Change Communication (BCC), with an intensive campaign at the community level to strengthen partnerships
• Early diagnosis and effective treatment of malaria cases
• Distribution of LLIN/treatment and re-treatment of ordinary nets
• Vector control through indoor residual spray
• Monitoring of program
• Quality control
• Capacity development of project staff
Grameen Swapana’s main approach to malaria control is to inform and educate people at the community level by promoting the use of insecticidal nets, and highlighting the importance of early diagnosis and prompt treatment. Long lasting insecticide treated nets (LLIN) are distributed to poor households and those households with pregnant women and children under five. The households having ordinary bed nets are treated with insecticides (K-O tab). Diagnostic and treatment services are delivered mainly through community-based health workers. Information, Education & Communication (IEC) materials are used regularly during health education sessions and individual communications. During health education sessions, information on prevention, symptoms, and facilities available for diagnosis and treatment of malaria are discussed. SAJIDA also conducts orientations with different stakeholders of the community to make them aware of malarial symptoms, to encourage the use of LLIN/ITNs, to enhance referrals of symptomatic cases for diagnosis by Rapid Diagnostic Tests (RDT) or Blood Slide Examinations (BSE), to ensure treatment and to reduce stigma.