Retrospective Analysis of School Based Malaria Treatment Programme and Impact on Health and Education Outcomes in Mangochi District, Malawi

This paper presents the findings of a retrospective evaluation of a school-based malaria treatment programme implemented in Mangochi district in Malawi, where malaria accounts for 40 per cent of outpatient visits, and eighteen per cent of all hospital deaths. It is a major cause of anaemia in children under the age of 5 years. Anaemia, in turn, is responsible for 40 per cent of all under-five hospitalisations. Mangochi district experiences perennial malaria transmission, which increases the vulnerability of students to malaria, and the risk of school absenteeism and drop-out. The proportion of Mangochi district’s malaria cases identified at outpatient departments (OPD) is 49 per cent.

School teachers were trained to identify and treat children suffering from malaria. The evaluation was undertaken using the school administrative records. The intervention and comparison schools were matched using propensity score matching. The impact was assessed using generalised linear modeling of family Poisson and also Kaplain Meier for survival analysis.

The author concludes that:

• School-based treatment programme implemented by Save the Children Fund was effective in reducing absenteeism and repetition.
• The programme further improved the skills of teachers and reporting of sickness among the pupils.
• Benefits of the proposed intervention would greatly exceed the costs, and it is feasible to reduce repetition cases for primary school pupils.
• Future studies should focus on exploring the feasibility of implementing Artemisinin based combined therapy (ACT) in primary schools using rapid diagnosis tools as this might increase effectiveness of the approach.
• Analysis on how the intervention can lead to reduction in disease burden would be important.