Malaria Border Posts
Mobile and Migrant Populations
More than 4 million registered migrants cross SADC borders every year. There are however no reliable estimates on the extent of irregular or “undocumented” movement, which is in fact represents the majority of migration flows, potentially double the volume of regular migrant traffic. The SADC region is experiencing a significant rise in both regular and irregular migration flows as the SADC population grows, and as the region moves increasingly towards economic integration. Differences in economic opportunities across the region also compel populations to travel, searching for work, trade, education, and healthcare.
Unfavorable policies and practices on migrant rights to health as well as social dynamics in border areas result in discrimination against mobile and migrant populations, preventing their right to health care. Insecurity, lack of economic livelihood, drought, and crop failure motivate migrants to undertake the risky migratory routes and to seek better opportunities across the region. These patterns all pose significant risks of malaria parasite movement across borders, undermining the elimination ambition for the region.
E8 Malaria Border Posts
E8 countries are collaborating across their borders to expand access to timely diagnosis and treatment for mobile and migrant populations moving across the region’s porous borders, in so doing, draining potential transmission reservoirs that support malaria importation across borders. A total of 50 mobile malaria posts and surveillance teams are being deployed across the borders of the E8 countries, with the goal of (i) providing early care to malaria diagnosis for travellers and underserved border populations, and (ii) tracking high risk populations and malaria risk in order to inform appropriate strategies to limit cross-border transmission. Modelling analysis combined with informant interviews haves been used to estimate the optimal locations for the deployment of the units, in an attempt to maximize the intended impact of draining sources of infection.
The following units are being deployed across the E8 borders between March and August 2017.
The “malaria plus” post will offer a more comprehensive package of primary health care services, and will be modelled after the primary health care facilities in the country where they are located. These are intended to provide services to boot underserved resident populations and mobile and migrant populations (MMPs) in the respective border towns.
The “malaria basic” posts are intended to provide care using more of a mobile or outreach model; these are aimed at providing services to mobile and migrant populations, and will be strategically placed in areas that are frequented by MMPs, such as bus stations, near border crossings (formal and informal) and shopping centres or markets.
In conjunction with the diagnosis and treatment activities, the project will include a program of active surveillance in order to proactively diagnose and track potential infections that are not presented through the passive surveillance system – that is, in the health facilities. Active surveillance is a key element of the elimination strategy, as it supports the identification of potential reservoirs of infection in the population that contribute towards ongoing transmission in the identified border areas.