Simple, effective solutions to combat malaria and save lives in Uganda

The Challenge

Uganda has the third highest number of deaths from malaria in Africa and some of the highest malaria transmission rates on the continent, devastating Uganda’s families and communities and damaging its economy and productivity. Although indoor residual spraying (IRS) programs are an effective way to combat malaria, implementation in rural areas needed improvement to ensure the most vulnerable populations were protected. 

The Solution

In 2009, Abt Associates – a global leader in research and program implementation in the fields of health, social/economic policy and international development – became the primary implementer of a US Agency for International Development-funded IRS program in Uganda that targeted the six districts where malaria was most prevalent. Two immediate challenges emerged: poor road conditions in rural areas hampered access and increased the already high cost of transporting workers to project areas, and the distance from banking services made it difficult to pay them. Abt, however, had extensive experience implementing programs to fight malaria across sub-Saharan Africa, and they reacted quickly and effectively to solve the local challenges. 

• When the project began, 40 percent of the budget was for transportation alone, driven by poor road conditions and the high cost of trucking workers to the villages where they were to spray each day and threatening the IRS program’s long-term sustainability. Abt initiated an innovative and effective solution, paying spray operators a $1/day “rental” fee to ride their own bikes to the assigned villages. This program increased the income of local workers and freed more resources for the program, widening its coverage and ensuring that daily targets were met.
• As a private sector actor looking for private sector solutions, Abt worked with PostBank Uganda to provide mobile banking services to spray operators, so they could receive their pay without needing a bank account and traveling long distances to a bank branch. This service saved them the cost of travel and increased their take-home income.

The Impact

Abt’s innovations stretched limited resources so that the spraying program effectively reached a larger population. The original goal had been to cover 85 percent of the population in the six targeted districts, but Abt’s nimble execution allowed 98 percent of the residents (2.7 million Ugandans) to be covered in the same time. On a human level, the results were evident at a hospital in Palabek district: the day before spraying began, the hospital pediatric ward was filled with patients, 90 percent of whom were children with malaria. One month later, the ward was nearly empty. By partnering with the country’s National Malaria Control Program, Abt’s strategies developed national as well as local capacity and ensured the program will continue.