Malaria

Rapid Access Expansion Programme (RAcE)

Diagnostic testing, treatment and high-risk groups icons

In 2012, the Government of Canada awarded a grant to the WHO Global Malaria Programme to support the scale-up of integrated community case management (iCCM) to provide diagnosis and treatment services of malaria, pneumonia and diarrhoea for children under 5 in sub-Saharan Africa. Through the Rapid Access Expansion Programme (RAcE), WHO has awarded implementation funding to nongovernmental organizations, selected through a competitive process.

Countries

Community health worker near Kalemie, DRC, disposes of her gloves after performing a malaria test on a young girl

The RAcE Programme was launched in Tanganyika Province in September 2013. The Programme’s aim is to improve access to services for malaria, pneumonia and diarrhoea for children under 5 living in hard-to-reach areas.

Tanganyika Province now has the country’s most extensive coverage for iCCM services. The RAcE Programme is the only programme to integrate the diagnosis and treatment of malaria, pneumonia and diarrhoea at the provincial level, and also the only one that aims to meet specific epidemiological needs, rather than to simply provide a single community care site per health district.

Nine-month-old Shakira is being treated for cough and fever at Matapila Village clinic, in Ntcheu

In April 2013, the RAcE Programme was launched in 4 districts in Malawi, with the aim of improving the coverage, scope and quality of existing iCCM services. The Programme, which has expanded to 8 districts, also piloted a number of new initiatives and documented best practices to support scale-up at the national level.

The coverage of iCCM services in RAcE-supported districts is better than in other districts of the country. Grantees report that RAcE areas have also seen improved quality of care; fewer stock outs of commodities for diagnosis and treatment; and more accurate, comprehensive and regular reporting of case management data.

A mother and child at Malhangalene Health Centre in Maputo, Mozambique

The RAcE Programme was launched in Mozambique in April 2013. Its focus is on improving the coverage and quality of the iCCM services provided by community health workers and in improving the data collected. Supervision visits and clinical assessments are critical success factors to ensure the health workers are providing quality iCCM services and to minimize data collection and reporting errors.

Since the launch of the RAcE Programme, the quality and frequency of supervision have increased, and coordination among implementing partners has improved.

A mother and child preparing for a health check up with the new mhealth application in Niger

Integrated community case management was introduced in Niger with the launch of the RAcE Programme on 1 July 2013. The iCCM programme in Niger delivers services to remote communities located more than 5 km from a health facility.

Four districts now provide community level iCCM services. Many communities are actively supporting their community health workers by building clinics, paying their transportation fees, and making financial or in-kind contributions for their services. The relais communautaires are selected by community members.

A father and his sick child waiting for treatment in Ruga Community, Niger State, Nigeria

Led by the Ministry of Health of Nigeria, the RAcE Programme was launched in November 2013 in Abia and Niger States. The aim of the programme is to deliver and monitor integrated community case management (iCCM) services in rural communities in hard to-reach areas.

The RAcE Programme has pioneered iCCM implementation in the country to the extent that its activities have led to the adoption of national guidelines for iCCM implementation.