Description
Introduction
Malaria is a public health problem in Nepal and Malaria Control Program is a priority-one public health program in the country. Free malaria control services are provided, with an emphasis on making services accessible to vulnerable, high-risk individuals as well as marginalized communities. The primary goal of the current malaria program is to eliminate transmission by strengthening the health systems to identify, characterize, delimit, and eliminate the foci as well as to confirm all suspected cases of malaria and treat those that have been confirmed. Additionally, the program aims to significantly reduce human-mosquito contact.
The aim of the study was to discuss the efforts and initiations made for malaria control in Nepal.
Methodology
Desk review was conducted. Different literatures, reports and policy documents related to Malaria control were reviewed and descriptive analysis was conducted.
Results and Discussions
Malaria control programme started in Nepal in 1954 focusing on Terai regions (plain areas) of central Nepal with the support from US. Nepal Malaria Eradication Programme was initiated in 1958 but in 1978 the concept was reverted back to control programme due to several technical, logistical and financial reasons and there was increase in malaria cases in the country in the 1970's. National Malaria Control Program developed National Plan of Operation for Malaria Control in 1994. The Roll Back Malaria initiatives was launched in 1998 for control of Malaria in targeted areas in the country. Since 1994, Malaria Risk Stratification was conducted to develop program interventions focusing on targeted and high risk areas, but as the cases of malaria decreased drastically, and malaria cases concentrated on specific areas, Malaria Risk Micro-Stratification was initiated.
In 2013, Nepal Malaria Strategic Plan 2014 - 2025 was developed to eliminate malaria by 2025, which has been updated in 2020 in line with the WHO's Global Technical Strategy for Malaria 2016 – 2030 and Framework for Malaria Elimination, 2017. To achieve the targets of Malaria elimination by 2025, Nepal has prepared various guidelines to facilitate the process. Nepal has prepared the Integrated Vector Management 2020, National Malaria Laboratory Plan 2020 – 2025, National Malaria Surveillance Guidelines 2019, National Malaria Treatment Protocol 2019. To track the progress towards Malaria Elimination, Nepal has also conducted Self-Audit of the National Malaria Program using the Malaria Elimination Audit Tool in 2021. The audit has highlighted key intervention areas that needs to be addressed urgently which includes monitoring and evaluation, surveillance and response and inter-sectoral collaboration for malaria elimination.
Conclusions
Although Nepal has made tremendous progress in the fight against malaria, there is a need to ensure universal access to quality malaria services for diagnosis, treatment, and prevention as well as prompt response during outbreaks. Implementation of effective preventive measures and targeted interventions are required to achieve malaria elimination in Nepal. Additionally, there is a further need to strengthen the monitoring and evaluation system, malaria surveillance and response and collaborative approaches to achieve the targets.
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