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Reducing the cost of fighting malaria through faith-based outreach Reducing the cost of fighting malaria through faith-based outreach
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The Department for International Development will soon become the third-largest provider of malaria support, behind only the USA and the Global Fund, according to the National Audit Office's report. It's a matter of some pride to those who want to see the UK maintain its commitment to the world's poorest despite strains on finances at home. The UK will invest another £494m on tackling this deadly but preventable disease in 2014/15. The number of deaths from malaria has already dropped from 755,000 in 2000 to an estimated 600,000 per year in 2010 – so progress can be made.The Department for International Development will soon become the third-largest provider of malaria support, behind only the USA and the Global Fund, according to the National Audit Office's report. It's a matter of some pride to those who want to see the UK maintain its commitment to the world's poorest despite strains on finances at home. The UK will invest another £494m on tackling this deadly but preventable disease in 2014/15. The number of deaths from malaria has already dropped from 755,000 in 2000 to an estimated 600,000 per year in 2010 – so progress can be made.
But the report makes the point that it can cost anywhere between $8 (£5) and $110 (£73) for each year of every life that is gained from the effective use of a bednet. That huge disparity is due to the unreliability of bednet distribution to the people who need them, and the likelihood of the net being used once a family owns it. In particular, there is disappointing news about the number of young children – the most vulnerable group – who are now sleeping under bednets. An impressive 5.3m bednets were distributed in the past three years as a result of DfID's funding. But on average just 6% more children under five are protected as a result.But the report makes the point that it can cost anywhere between $8 (£5) and $110 (£73) for each year of every life that is gained from the effective use of a bednet. That huge disparity is due to the unreliability of bednet distribution to the people who need them, and the likelihood of the net being used once a family owns it. In particular, there is disappointing news about the number of young children – the most vulnerable group – who are now sleeping under bednets. An impressive 5.3m bednets were distributed in the past three years as a result of DfID's funding. But on average just 6% more children under five are protected as a result.
How could more children be protected? And how can donors ensure they are delivering value for money in their malaria-prevention programme?How could more children be protected? And how can donors ensure they are delivering value for money in their malaria-prevention programme?
The NAO report offers several recommendations. Among them: stimulate a "market in ideas", so that innovative and effective approaches are adopted. Get better at mobilising domestic resources in developing countries. Support net distribution campaigns with timely information campaigns to increase net usage. Work with other donors to measure impacts more effectively – in particular trying to find reliable and frequent data on outcomes (malaria incidences reduced) as well as outputs (nets distributed). All very sensible stuff.The NAO report offers several recommendations. Among them: stimulate a "market in ideas", so that innovative and effective approaches are adopted. Get better at mobilising domestic resources in developing countries. Support net distribution campaigns with timely information campaigns to increase net usage. Work with other donors to measure impacts more effectively – in particular trying to find reliable and frequent data on outcomes (malaria incidences reduced) as well as outputs (nets distributed). All very sensible stuff.
I'd like to add another, very specific suggestion: improve the impact and reach of awareness raising campaigns by working with local faith communities.I'd like to add another, very specific suggestion: improve the impact and reach of awareness raising campaigns by working with local faith communities.
Since 2011 the Tony Blair Faith Foundation has been supporting Muslim and Christian leaders in Sierra Leone to train over 8,000 members of their congregations, who then conduct household visits training people how to prevent malaria, including how to use bednets. This cascade approach of volunteer community education has now reached more than 1.2m households in just 18 months (a fifth of the population) – with 78.5% of those households able to demonstrate clear recall of the key messages and proper use of the bednet one month later.Since 2011 the Tony Blair Faith Foundation has been supporting Muslim and Christian leaders in Sierra Leone to train over 8,000 members of their congregations, who then conduct household visits training people how to prevent malaria, including how to use bednets. This cascade approach of volunteer community education has now reached more than 1.2m households in just 18 months (a fifth of the population) – with 78.5% of those households able to demonstrate clear recall of the key messages and proper use of the bednet one month later.
Based on the high levels of trust of religious leaders and their congregations, it is an extremely cost-effective and sustainable approach. There are some huge advantages to this method. Working with government so we can complement, not compete with, national malaria control plans, faith communities provide access to hard-to-reach communities through their networks that other government or medic-led networks cannot achieve consistently. And it's not just the social capital in these networks that can help boost positive outcomes. Because these communities volunteer on the basis of their religious motivation and compassion for the community, it's cost-effective.Based on the high levels of trust of religious leaders and their congregations, it is an extremely cost-effective and sustainable approach. There are some huge advantages to this method. Working with government so we can complement, not compete with, national malaria control plans, faith communities provide access to hard-to-reach communities through their networks that other government or medic-led networks cannot achieve consistently. And it's not just the social capital in these networks that can help boost positive outcomes. Because these communities volunteer on the basis of their religious motivation and compassion for the community, it's cost-effective.
We estimate, from the robust data collected and practically through the programme running over 18 months, that it costs less than 35 pence per person in each household who is able to show our teams of multi-faith educators that they now know how to protect their family from the disease. This model works best when run across all faith communities in a particular demographic, to ensure the reach and collaboration between communities, and also ideally in conjunction with government plans where they exist so a bottom up approach is supporting what is happening top down.We estimate, from the robust data collected and practically through the programme running over 18 months, that it costs less than 35 pence per person in each household who is able to show our teams of multi-faith educators that they now know how to protect their family from the disease. This model works best when run across all faith communities in a particular demographic, to ensure the reach and collaboration between communities, and also ideally in conjunction with government plans where they exist so a bottom up approach is supporting what is happening top down.
As the NAO report observes, one problem is organisations lacking the capacity to ensure consistent roll-out of education campaigns. Some campaigns have made a real difference, as Malaria No More's highly effective work has shown, through their mass media campaigns and distribution techniques. But it's hard to reach everywhere, particularly when public education work is generally a poorly-funded relation of the higher profile commodity purchases. The clear advantage of faith-based approaches to this is that churches and mosques are everywhere, even in the remotest of areas. Often already the hub of local life, they're not trying to reach local communities – they are local communities.As the NAO report observes, one problem is organisations lacking the capacity to ensure consistent roll-out of education campaigns. Some campaigns have made a real difference, as Malaria No More's highly effective work has shown, through their mass media campaigns and distribution techniques. But it's hard to reach everywhere, particularly when public education work is generally a poorly-funded relation of the higher profile commodity purchases. The clear advantage of faith-based approaches to this is that churches and mosques are everywhere, even in the remotest of areas. Often already the hub of local life, they're not trying to reach local communities – they are local communities.
No-one wants to see hundreds of millions of pounds spent on the production and supply of bednets if they aren't used. Spend just 35 pence more per person in supporting the roll-out of highly-effective faith-based and community-based education, and we might just see more of DfID's initial investment come good.No-one wants to see hundreds of millions of pounds spent on the production and supply of bednets if they aren't used. Spend just 35 pence more per person in supporting the roll-out of highly-effective faith-based and community-based education, and we might just see more of DfID's initial investment come good.
Ruth Turner is director of policy at the Tony Blair Faith Foundation. Follow them on Twitter: @Tonyblair_TBFFRuth Turner is director of policy at the Tony Blair Faith Foundation. Follow them on Twitter: @Tonyblair_TBFF
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