Poster Presentation First Malaria World Congress 2018

Assessment of health-care system and its potential impact on the persistence of malaria transmission in selected areas of North – Western and Southern regions of Tanzania (#247)

Frank Chacky 1 , Susan F Rumisha 2 , Mercy Chiduo 3 , Celine I Mandara 3 , Renata Mandike 1 , Sigsbert Mkude 1 , Fabrizio Molteni 4 , Mohamed Ally 1 , Deus S Ishengoma 3
  1. Ministry of Health, Community Development, Gender, Elderly and Children; National Malaria Control Programme, Dodoma, DODOMA, Tanzania, United Republic of
  2. Medical Research, National Institute for Medical Research, Dar es Salaam, Tanzania, United Republic of
  3. Medical Research, National Institute for Medical Research, Tanga, Tanzania, United Republic of
  4. Swiss TPH, Netcell Project, Dar es Salaam, Tanzania, United Republic of


Although recent reports have shown a dramatic drop of malaria burden in Tanzania, some parts still have prevalence of >50%. Thus, current interventions might be insufficient and less likely to achieve malaria elimination targets. This study was conducted to establish health system factors which might be associated with the observed malaria resilience and recommend new strategies for malaria control.


The study was conducted in eight councils of Uvinza and Buhigwe (Kigoma); Chato and Nyang’hwale (Geita); Nanyumbu and Mtwara DC (Mtwara) and Nyasa and Tunduru (Ruvuma). Assessment of health facilities and accredited drug dispensing outlets serving 16 selected villages (two per council) was conducted from September to November 2017. Information on availability, accessibility, affordability and quality of malaria services was collected through observations, records review, exit interviews and providers’ interview.


A total of 31 health facilities (HFs) were assessed; including 6 hospitals (19.4%); 13 health centres (41.9%) and 12 dispensaries (38.7%). Over 31% were located between 0-10km from the district medical office while 41% were located less than 50kms and the rest were 50 -120 km. About 33% of the HFs had ≤ 5 health workers and some having only one, while four (12.9%) had no clinician. Suspected malaria cases were mostly checked on the presence of fever, its duration and their age. Taking history on previous treatment/medication was not adequately done. Late booking for antenatal care was observed among pregnant women and was more pronounced among women with high number of gravida.


Despite availability of HFs, accessibility and quality of services could be limited by long distance for referral at the district hospital and shortage of health workers. Patients were not properly assessed, and case management of pregnant women was more likely to be inadequate due to late booking for antenatal care.

  1. References 1. WHO: World malaria report 2014. In: Avarilable: http://www who int/malaria/publications/world_ malaria_report_2014/en/ Accessed. vol. 24. Geneva: WHO; 2014. 2. National Malaria Control Programme (Tanzania), WHO (Tanzania), Ifakara Health Institute (Tanzania), KEMRI-Wellcome Trust (Kenya) (2013). An epidemiological profile of malaria and its control in mainland Tanzania. Report funded by Roll Back Malaria and Department for International Development-UK, July 2013. 3. URT, MoHCDGEC/NMCP. National Malaria Strategic Plan 2015 - 2020 - Available from: