Global Health Initiative and President’s Malaria Initiative

	A laboratory technician at a hospital in Benin examines a slide under a microscope provided by PMI. Diagnostic testing for malaria enables health care workers to distinguish malaria from other causes of fever. PMI has helped to build capacity through training for health workers in malaria diagnosis and treatment. Source: Simplice Takoubo/PMI

Build sustainability through health systems strengthening

Across malaria-endemic countries in Africa, an average of 25 to 35 percent of all outpatient clinic visits are for malaria. In these same countries, between 20 and 45 percent of all hospital admissions are caused by malaria. Given the high burden malaria imposes on overstretched health systems, malaria control provides an important platform on which to base additional efforts to strengthen these systems. Due to late presentation at a health facility, inadequate clinical management, and frequent unavailability of effective drugs, case fatality rates among hospitalized malaria patients range from 15 to 35 percent among all age groups. Where effective malaria control has been achieved in high-burden areas, the result has been fewer outpatient clinic visits and a dramatic reduction in hospitalizations for malaria. This “unburdening” of the health system frees up health care workers and hospital beds, creating opportunities for the health care system to function more efficiently and deal with other important issues. During the past four years, PMI has supported the sustainability of its programs by strengthening health systems and building the capacities of public and private sector health workers and managers. All PMI activities directly support national malaria control strategies and plans and are implemented with national ministries of health. PMI will continue this approach, with the long-term goal of ensuring that the gains achieved with PMI and other donor support can be sustained. While the focus will remain on malaria, PMI will work to:

• Improve forecasting, procurement, quality control, storage, and distribution of medicines
• Strengthen disease surveillance and program monitoring and evaluation within ministries of health
• Improve service delivery by integrating malaria prevention and treatment activities with other disease control and maternal and child health programs
• Help build host country managerial and technical capacity related to malaria control
• Improve the quality of laboratory diagnostic services
• Build technical and managerial capacity of malaria program staff

As part of its investments in health systems strengthening, PMI will track improvements in the functioning of key health systems (e.g., pharmaceutical management systems and health management information systems) at the country level.