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RBM COUNTRY NEEDS ASSESSMENT by yho59756

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									ROLL BACK MALARIA
COUNTRY NEEDS ASSESSMENT

NAME OF COUNTRY

Day Month 2008
                                                 Malaria Consortium - RBM Country Needs Assessment Month 2008




Table of Contents

Acknowledgements ................................................................................................... 2
Executive summary ................................................................................................... 2
List of acronyms ........................................................................................................ 2
List of tables .............................................................................................................. 2
List of figures ............................................................................................................. 3
1. Introduction ........................................................................................................ 4
2. Methodology ...................................................................................................... 4
3. Demographic, socio-economic and epidemiological profile ................................ 4
4. Progress, estimated gaps and requirements ...................................................... 6
   4.1. Progress towards 2010 targets ....................................................................... 6
   4.2. Current financing .......................................................................................... 10
   4.3. Estimated gaps and requirements to attain 2010 targets .............................. 12
5. Core interventions ............................................................................................ 21
   5.1. Prevention .................................................................................................... 21
     5.1.1. ITNs ....................................................................................................... 21
     5.1.2. IRS ......................................................................................................... 23
     5.1.3. Larval control.......................................................................................... 24
     5.1.4. Malaria in Pregnancy (IPT) ..................................................................... 25
   5.2. Case Management ....................................................................................... 27
     5.2.1. Diagnosis ............................................................................................... 27
     5.2.2. Treatment ............................................................................................... 30
6. Cross-cutting issues ............................................................................................ 32
   6.1. Epidemic/Emergency Control ....................................................................... 32
   6.2. Advocacy/BCC/IEC ...................................................................................... 33
   6.3. Surveillance, Monitoring and Evaluation & Operational research .................. 34
7. Program Management and Health Systems ........................................................ 36
   7.1. Program Management and Health Systems ................................................. 36
   7.2. Supply management ..................................................................................... 37
   7.3. Health Systems Strengthening ..................................................................... 38
ANNEXES ............................................................................................................... 42
 Update list once report is complete to ensure page numbers are accurate




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                                                  Malaria Consortium - RBM Country Needs Assessment Month 2008




Acknowledgements
Executive summary
List of acronyms
List of tables
Table 1. Socio-economic and health indicators ......................................................... 4
Table 2. Demography ................................................................................................ 5
Table 3. Population at risk of malaria by epidemiological stratification ....................... 5
Table 4. RBM Core (and Country-specific) Indicators and Targets ............................ 7
Table 5. Main Donors and Areas of Support ............................................................ 11
Table 6. Current financing by year (2008-2013) (USD)............................................ 11
Table 7. Summary of targets, strategies, progress and additional activities needed by
core intervention area.............................................................................................. 12
Table 8a. Summary of overall funding gaps: by intervention area (USD) ................. 13
Table 8b. Summary of overall funding gaps: by cost type (USD) ............................. 13
Table 9. Summary of major commodity requirementsTable 10a. Funding
Requirements Linked to Targets – Commodity and delivery costs, ITNs (USD) ...... 14
Table 10a. Funding Requirements Linked to Targets – Commodity and delivery
costs, ITNs (USD) ................................................................................................... 15
Table 10b. Funding Requirements Linked to Targets – Commodity and delivery
costs, IRS (USD) ..................................................................................................... 15
Table 10c. Funding Requirements Linked to Targets – Commodity costs, IPT (USD)
................................................................................................................................ 16
Table 10d. Funding Requirements Linked to Targets – Commodity costs, Diagnosis
(USD) ...................................................................................................................... 16
Table 10e. Funding Requirements Linked to Targets – Commodity costs, Treatment
(USD) ...................................................................................................................... 18
Table 11. Funding Requirements - Crossing cutting areas (USD) ........................... 19
Table 12. ITN funding and major commodity needs to attain RBM 2010 Targets
(costs in USD) ......................................................................................................... 22
Table 13. IRS funding and major commodity needs to support national scale up plans
at RBM 2010 coverage targets (costs in USD) ........................................................ 23
Table 14. Larval Control and Environmental Management funding needs (costs in
USD) ....................................................................................................................... 24
Table 15. IPT funding and major commodity needs to attain RBM 2010 targets (costs
in USD) ................................................................................................................... 25
Table 16. Diagnostic services funding and major commodity needs to attain RBM
2010 targets (costs in USD) .................................................................................... 28
Table 17. Treatment funding and major commodity needs to attain RBM 2010 targets
(costs in USD) ......................................................................................................... 31
Table 18. Epidemics and emergencies funding needs (costs in USD) ..................... 32
Table 19. Advocacy, IEC / BCC funding needs (costs in USD) ................................ 33
Table 20. Surveillance, monitoring & evaluation and operational Research funding
needs (costs in USD) .............................................................................................. 35
Table 21. RBM partners, roles and coverage/implementation capacity and support
needs ...................................................................................................................... 36
Table 22. Actual staffing, staffing norms and requirements ..................................... 38
Table 23. Public Health facilities and infrastructure ................................................ 39
Table 24. Summary of Program Management and Institutional Strengthening funding
needs ...................................................................................................................... 40


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                                       Malaria Consortium - RBM Country Needs Assessment Month 2008



Table 25. Cost breakdown for larval control / environmental management .............. 42
Table 26. No. Health facilities by diagnostic method................................................ 42
Table 27. Advocacy, BCC & IEC funding needs by activity (costs in USD) .............. 42
Update list once report is complete to ensure page numbers are accurate

List of figures




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                                    Malaria Consortium - RBM Country Needs Assessment Month 2008



Throughout this report format instructions are provided in italicised, yellow highlighted
text. These sections should be followed and then removed in the final version.

1. Introduction
Provide an outline of the background to the needs assessment; the composition of
the assessment team; dates of visit etc.




2. Methodology
Describe the methodology the team used including: interviews held; key documents
reviewed; any field or site visits; stakeholders and consensus meetings held, etc.



3. Demographic, socio-economic and epidemiological
   profile
Insert short narrative describing pertinent points from the data in the tables

Table 1. Socio-economic and health indicators
 Indicator                           Rate/Ratio                      Source (and year)
 Crude Birth Rate
 Crude Death Rate
 Growth Rate
 Infant Mortality
 Child Mortality
 Under Five Mortality
 Maternal Mortality Ratio
 Women receiving Antenatal Care
 Deliveries by professionals
 Total Fertility Rate
 HIV prevalence in 14-49yr cohort
 Life expectancy
 Literacy
 Population below poverty line
 Other




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                                     Malaria Consortium - RBM Country Needs Assessment Month 2008



Table 2. Demography
                                                                                           Source
 Indicator                2008       2009      2010       2011       2012        2013      (and
                                                                                           year)

 Total population

 Average Household
 Size

 Total households

 Number of pregnant
 woman*

 Number of infant

 Number of under-
 fives*
  Percentage of
  population living in
  urban areas
*Calculation tool has some preloaded estimates that may be used (source for these is given
on the population sheet of the calculation tool). See notes in calculation tool on instructions
when these pre-loaded data are different to locally used data.
If data are unavailable both in country and in the calculation tool pre-loaded selections then
estimate at 5% of total population for pregnant women and 18% for children under five – state
estimate as source.

Include paragraph describing the epidemiology of malaria and including the main
parasite and vector species

Table 3. Population at risk of malaria by epidemiological stratification
 Indicator                                   Number        Percentage     Source (and year)
 Population living in stable malaria areas

 Population living in unstable malaria
 areas

 Population living in malaria free areas




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                                  Malaria Consortium - RBM Country Needs Assessment Month 2008




4. Progress, estimated gaps and requirements
4.1. Progress towards 2010 targets

Add to Table 4 any country-specific core indicators that are not included.
Indicators currently listed that are not relevant to the country can be ignored.

Provide a narrative section following this table including:
      Where RBM 2010 and country targets greatly differ report on the discussion
       about this held with NMCP and any relevant country issues.
      Where appropriate, indicate where targets may be either unrealistic or overly
       conservative.
      Discussing the country setting in terms of infrastructure and political stability
       may be useful to illustrate why some targets may not be attainable, even
       assuming accelerated high level funding.




                                            6
Table 4. RBM Core (and Country-specific) Indicators and Targets1

                                           Baseline        NMCP             NMCP            NMCP            NMCP            NMCP            NMCP     RBM         NMCP
Indicators                                 Year            Target           Target          Target          Target          Target          Target   Target      Achieved
                                           (indicate)      2008             2009            2010            2011            2012            2013     2010        2006/2007


Crude death rate (under five)
                                                                                                                                                      50%
Mortality attributed to malaria
                                                                                                                                                     reduction
(all ages)                                                                                                                                           from 2000
                                                                                                                                                     50%
Mortality attributed to malaria                                                                                                                      reduction
(under five)                                                                                                                                         from 2000
                                                                                                                                                     50%
Mortality attributed to malaria                                                                                                                      reduction
(5 and above)                                                                                                                                        from 2000
                                                                                                                                                     50%
Morbidity attributed to malaria                                                                                                                      reduction
(all ages)                                                                                                                                           from 2000
                                                                                                                                                     50%
Morbidity attributed to malaria                                                                                                                      reduction
(under five)                                                                                                                                         from 2000
                                                                                                                                                     50%
Morbidity attributed to malaria
                                                                                                                                                     reduction
(5 and above)                                                                                                                                        from 2000
                                                                                                                                                     50%
Case fatality rate (under five)                                                                                                                      reduction
                                                                                                                                                     from 2000
                                                                                                                                                     50%
Case fatality rate (five and above)                                                                                                                  reduction
                                                                                                                                                     from 2000
% of under fives with fever getting
appropriate treatment within 24                                                                                                                      80%
hours of onset



1
Original RBM 2010 targets: http://rbm.who.int/docs/abuja_declaration.pdf
Updated RBM 2010 targets:http://www.who.int/gb/ebwha/pdf_files/WHA58-REC1/english/Resolutions.pdf and http://rbm.who.int/forumV/docs/gsp_en.pdf
                                                                                        Malaria Consortium - RBM Country Needs Assessment Month 2008




                                       Baseline     NMCP     NMCP     NMCP     NMCP           NMCP           NMCP          RBM            NMCP
Indicators                             Year         Target   Target   Target   Target         Target         Target        Target         Achieved
                                       (indicate)   2008     2009     2010     2011           2012           2013          2010           2006/2007

% of fever/uncomplicated malaria
under five cases correctly
managed at health facilities
% of severe malaria cases (under-
five) correctly managed at health
facilities
Proportion of inpatients cases due
to malaria all ages
Proportion of inpatients cases due
to malaria under five
Proportion of inpatients cases due
to malaria five and above
% pregnant women taking at least
                                                                                                                           80%
2 doses of SP for IPT
Proportion of the population at risk
from malaria who are protected by
                                                                                                                           80%
appropriate prevention measures
(ITNs or IRS)
% pregnant women sleeping under
                                                                                                                           80%
an ITN

Proportion of pregnant women
sleeping under any mosquito net

% of under fives sleeping under an
                                                                                                                           80%
ITN
% of under fives sleeping under
any mosquito net




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                                                                                      Malaria Consortium - RBM Country Needs Assessment Month 2008




                                     Baseline     NMCP     NMCP     NMCP     NMCP           NMCP           NMCP          RBM            NMCP
Indicators                           Year         Target   Target   Target   Target         Target         Target        Target         Achieved
                                     (indicate)   2008     2009     2010     2011           2012           2013          2010           2006/2007

% of mosquito nets treated with
insecticide within the last 12
months
% of households having at least
one ITN
Proportion of population sleeping
under any mosquito net
                                                                                                                         At least
Proportion of houses or structures                                                                                       80% in
in targeted areas that are sprayed                                                                                       targeted
                                                                                                                         areas
Proportion of the population
protected by IRS




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                                  Malaria Consortium - RBM Country Needs Assessment Month 2008




4.2. Current financing
Include a narrative describing overall financing for malaria control. Include: In context
of health budget overall national budget and what percentage is allocated to health.




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                                                                                          Malaria Consortium - RBM Country Needs Assessment Month 2008




Table 5. Main Donors and Areas of Support
                                                                    Areas of Support
                                          Larval                                                                                  Program
                      ITNs       IRS                   IPT      Diagnosis     Treatment      IEC/BCC     Epidemics       M&E
Organization                              Control                                                                                 Mangmt
Ministry of Health
GFATM
PMI
WB Booster
UNICEF
Other
Other




Table 6. Current financing by year (2008-2013) (USD)
Organization          2008        2009         2010          2011          2012        2013          Source
Ministry of Health
GFATM
PMI
WB Booster
UNICEF
Other
Other
Total Funds
Available ($)




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                                  Malaria Consortium - RBM Country Needs Assessment Month 2008




4.3. Estimated gaps and requirements to attain 2010 targets

Tables 7 – 11 are summary tables of all requirements, both financial and commodity
related (Tables 8 -11) and otherwise (Table 7).

Provide a narrative describing the tables below.

In this narrative section include a clear bulleted list of any TA support needs
recommended as below:

Summary of Technical Assistance Needs
   E.g. Developing PSM system
   E.g. Design of system for distributing LLINs through ANCs
   E.g. Training on IEC BCC techniques for health workers

Table 7. Summary of targets, strategies, progress and additional activities
needed by core intervention area.

                                  Strategies and                          Additional
Core                                                  Progress and
                Key targets       approaches to                           activities
interventions                                         bottlenecks
                                  achieve targets                         needed

ITNs
IRS
Malaria in
Pregnancy
Diagnosis
Treatment




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                                                                                           Malaria Consortium - RBM Country Needs Assessment Month 2008


Table 8a. Summary of overall funding gaps: by intervention area (USD)
 Core interventions              2008            2009            2010            2011             2012               2013             TOTAL

 ITNs
 IRS
 IPT
 Diagnosis
 Treatment
 IEC
 Epidemics & Emergencies
 M&E
 Management
 TOTAL
* This table is compiled as a summary of the financial gaps to reach 2010 targets as detailed in Tables 10a-e & Table 11

Table 8b. Summary of overall funding gaps: by cost type (USD)
 Cost type                       2008            2009            2010            2011             2012               2013             TOTAL

 Commodities
 Delivery costs
 Infrastructure
 Operational costs
 Training
 IEC
 Monitoring & Evaluation
 Management
 TOTAL
* This table should be compiled from more detailed tables from section 5 of this report onwards combined with in country cost estimates of
breakdowns by cost type. Use cost type categories as appropriate.


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                                                                       Malaria Consortium - RBM Country Needs Assessment Month 2008




Table 9. Summary of major commodity requirements

Commodity                                 2008     2009        2010   2011            2012             2013             TOTAL

               Target coverage (RBM or
               national if higher)
               No. required (RBM /
   LLINs
               national targets)
               GAP – no. of LLINs
               Target coverage (RBM or
               national if higher)
Insecticide    No. required (RBM /
  for IRS      national targets)
               GAP – No. of units
               insecticide
               Target coverage (RBM or
               national if higher)
               No. required (RBM /
   RDTs
               national targets)
               GAP – No. of RDTs
               Target coverage (RBM or
               national if higher)
    st
  1 line       No. doses required (RBM
malaria drug   / national targets)
                                   st
               GAP – number of 1 line
               doses
               Target coverage (RBM or
               national if higher)
               No. of doses required
 SP for IPT
               (RBM / national targets)
               GAP – No. of SP doses




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                                                                                              Malaria Consortium - RBM Country Needs Assessment Month 2008




Table 10a. Funding Requirements Linked to Targets – Commodity and delivery costs, ITNs (USD)
ITNs                                 2008             2009            2010             2011               2012              2013             TOTAL
Financial need for 100%
coverage
RBM Target
(or national target if higher)*
Financial needs to reach RBM (or
national) target
Resources available
GAP TO REACH RBM TARGET
(or national if higher)
* Note only commodity and delivery costs are included in the above figures. All cross cutting costs are included in Table 9.
** For the purposes of the table RBM target should be reached by 2010 and remain constant thereafter.
*** Calculation Tool will help with this table.

Table 10b. Funding Requirements Linked to Targets – Commodity and delivery costs, IRS (USD)
IRS                                  2008             2009            2010             2011               2012              2013             TOTAL
Financial need for national plans
at RBM targeted coverage level
of 80%

Resources available


GAP to fulfil national plans

* Note only commodity and delivery costs are included in the above figures. All cross cutting costs are included in Table 9.
** For IRS it is not applicable to differentiate between 100% and RBM targets. Costs are based on country scale up plans. RBM targets are
related to coverage within targeted communities. Country budgets will be generated based on costs for completing IRS in specified areas of the
country. The budgets will always be costed for spraying 100% of households / structures in those areas. The target of 80% coverage does not
have any implication on budgeting or resources required and therefore is not included as part of this table.
*** Calculation Tool will help with this table.


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                                                                                          Malaria Consortium - RBM Country Needs Assessment Month 2008




Table 10c. Funding Requirements Linked to Targets – Commodity costs, IPT (USD)
IPT                                 2008            2009            2010           2011               2012              2013             TOTAL
Financial need for 100%
coverage
RBM Target
(or national target if higher)*
Financial needs to reach RBM
(or national) target
Resources available
GAP TO REACH RBM TARGET
(or national if higher)
* For the purposes of the table RBM target should be reached by 2010 and remain constant thereafter
** Calculation Tool will help with this table.
Note for Tables 10c – e. Only commodity rather than commodity and delivery costs should be presented. Complete delivery costs for treatment
and diagnosis are considered broader health system costs that do not fall under a malaria specific funding need. Issues that are specific to
these malaria areas and can be considered a factor in delivery costs such as training and supervision are included elsewhere in the health
systems, program management and institutional strengthening sections.

Table 10d. Funding Requirements Linked to Targets – Commodity costs, Diagnosis (USD)
DIAGNOSIS                           2008            2009            2010           2011               2012              2013             TOTAL
Financial need for 100%
coverage
RBM Target
(or national target if higher)*
Financial needs to reach RBM
(or national) target
Resources available
FUNDING GAP TO REACH
RBM TARGET
(or national if higher)
* For the purposes of the table RBM target should be reached by 2010 and remain constant thereafter


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                                                      Malaria Consortium - RBM Country Needs Assessment Month 2008




** Calculation Tool will help with this table.




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                                                                                          Malaria Consortium - RBM Country Needs Assessment Month 2008




Table 10e. Funding Requirements Linked to Targets – Commodity costs, Treatment (USD)
TREATMENT                           2008           2009            2010            2011               2012              2013             TOTAL
Financial need for 100%
coverage
RBM Target
(or national target if higher)*
Financial needs to reach RBM
(or national) target
Resources available
FUNDING GAP TO REACH
RBM TARGET
(or national if higher)
* For the purposes of the table RBM target should be reached by 2010 and remain constant thereafter
** Calculation Tool will help with this table.




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                                                                                             Malaria Consortium - RBM Country Needs Assessment Month 2008




Table 11. Funding Requirements - Crossing cutting areas (USD)
Intervention area                    2008            2009             2010            2011               2012              2013             TOTAL

IEC
                    Financial need
            Resources available
                             GAP
M&E:
                    Financial need
            Resources Available
                             GAP
Management
                    Financial need
            Resources Available
                             GAP
Other (e.g. TA)
                    Financial need
            Resources Available
                             GAP
TOTAL NEED
TOTAL AVAILABLE
TOTAL GAP
* Table 11 includes total costs and gaps in cross cutting areas to support full national scale up. It is expected that RBM 80% targets for
commodity delivery and use will only be reached if these cross cutting areas are fully supported. There is therefore no breakdown into costs for
full scale up versus 80% scale up for these cross cutting areas.


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                                    Malaria Consortium - RBM Country Needs Assessment Month 2008




These financial summary tables should be followed by a narrative section discussing
absorptive capacity of the country based both on previous experience, expectations
given the recommended assistance to management areas as well as the country setting
(e.g. conflict affected).

The financial targets summarized in Tables 7 and 8 should be overall needs to meet
2010 targets but it is the role of the team carrying out the needs assessment to make
informed judgments about the feasibility of achieving targets and therefore whether these
funding gaps can appropriately be translated into sensible funding requests.




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                                Malaria Consortium - RBM Country Needs Assessment Month 2008




5. Core interventions
5.1. Prevention
5.1.1. ITNs

The narrative for each core intervention should include the subheadings given below
and should included information on all relevant issues as outlined in the
GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status
       Management and partners’ roles
       Procurement and logistics
       Communications
       M&E

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such
as human resource/TA needs, should also be described but will be budgeted under
the relevant cross cutting sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
        Include TA needs with estimated costs in narrative




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                                                                                                           Malaria Consortium - RBM Country Needs Assessment Month 2008


Table 12. ITN funding and major commodity needs to attain RBM 2010 Targets (costs in USD)
Number and cost of LLINs to be delivered to achieve
target
                                                                      2008           2009           2010          2011           2012          2013           Total
Delivery Approach 1 (specify)
A. Average cost per LLIN delivered*
B. Number of LLINs to be delivered
to reach 100% coverage
C. Number of LLINs to be delivered
to reach RBM targets (or national if higher)
D. Available resources for LLIN distribution
E. Funding gap for RBM / National (A1 * C1) – D1
Delivery Approach 2 (specify)
A. Average cost per LLIN delivered*
B. Number of LLINs to be delivered
to reach 100% coverage
C. Number of LLINs to be delivered
to reach RBM targets (or national if higher)
D. Available resources for LLIN distribution
E. Funding gap for RBM / National (A1 * C1) – D1

TOTAL number of LLINs to be delivered to achieve 100%
coverage (B1+B2+B3)
TOTAL number of LLINs to be delivered to achieve RBM
targets (or national if higher) (C1+C2+C3)
TOTAL available resources for LLIN distribution
(D1+D2+D3)
TOTAL FUNDING GAP
to reach RBM targets (or national if higher) (E1 + E2 + E3)
COMMODITY GAP to reach RBM targets (or national if
higher) – number of LLINs
   *Total costs in this table include the cost of the LLIN and delivery only. Other cross cutting costs such as IEC are included in later cross cutting costings.
   ** Delivery approaches may include campaigns, routine distribution through ANC, EPI etc.
   *** Calculation Tool will help with this table.




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                                                       Malaria Consortium - RBM Country Needs Assessment Month 2008




5.1.2. IRS

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status
       Management and partners’ roles
       Procurement and logistics
       Communications
       M&E

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
        Include TA needs with estimated costs in narrative

Table 13. IRS funding and major commodity needs to support national scale up plans at RBM
2010 coverage targets (costs in USD)
Number and cost of
households (HH) to be            2008           2009         2010       2011        2012         2013        Total
sprayed
A. Average cost per HH
sprayed*
B. Total number of HH
targeted to be sprayed
C. Available resources for
IRS
FUNDING GAP
(A * B) - C
Total amount of insecticide
required (specify type and
units)
COMMODITY GAP - units
of insecticide
* Calculation Tool will help with this table.




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                                                    Malaria Consortium - RBM Country Needs Assessment Month 2008




5.1.3. Larval control

NB. For the majority of countries, this will not be applicable or a minor intervention

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status
       Management and partners’ roles
       Procurement and logistics
       Communications
       M&E

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
        Include TA needs with estimated costs in narrative

Table 14. Larval Control and Environmental Management funding needs (costs in USD)
Cost of larviciding/
Environmental               2008          2009           2010       2011       2012        2013        Total
Management
A. Cost of
Intervention*
B. Available
resources
FUNDING GAP
(A - B)
* There is no detailed calculation tool for larviciding / environmental management. Table 25 in the Annex may
help to guide a calculation of a summary cost using national costing data.




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                                               Malaria Consortium - RBM Country Needs Assessment Month 2008




5.1.4. Malaria in Pregnancy (IPT)

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status
       Management and partners’ roles
       Procurement and logistics
       Communications
       M&E

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
        Include TA needs with estimated costs in narrative


Table 15. IPT funding and major commodity needs to attain RBM 2010 targets (costs in USD)
Number and
cost of pregnant
women
                    2008       2009       2010        2011         2012         2013        Total
receiving IPT
A. Average Cost
of IPT (2 doses)
per pregnant
woman*
B. Number of
pregnant women
targeted to reach
100% coverage

C. Number of
pregnant women
targeted to reach
RBM targets (or
national if
higher)

D. Available
resources for IPT
FUNDING GAP
to reach RBM
targets (or
national if
higher) (A*C) - D
Total number of
SP doses
required to
reach RBM



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                                                Malaria Consortium - RBM Country Needs Assessment Month 2008



targets (or
national if
higher)
COMMODITY
GAP to reach
RBM targets (or
national if
higher) -
number of SP
doses
* Calculation Tool will help with this table.




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                                                Malaria Consortium - RBM Country Needs Assessment Month 2008




5.2. Case Management
5.2.1. Diagnosis

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.


a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status
       Management and partners’ roles
       Procurement and logistics
       Communications
       M&E
Note a table of detailed diagnostic services is included as a possible annex in Table 26.

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
        Include TA needs with estimated costs in narrative




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                                                                                          Malaria Consortium - RBM Country Needs Assessment Month 2008


Table 16. Diagnostic services funding and major commodity needs to attain RBM 2010 targets (costs in USD)
Number and
cost of                            2008            2009            2010            2011              2012               2013               TOTAL
                  Age Group
malaria
diagnostic                     Micro-          Micro-          Micro-          Micro-          Micro-              Micro-             Micro-
                                        RDTs            RDTs            RDTs            RDTs             RDTs                RDTs                RDTs
services                       scopy           scopy           scopy           scopy           scopy               scopy              scopy
A. Average
cost per          All
diagnostic test
B. Number of
                  < 5 yrs
suspected
malaria (fever)   > 5 yrs
cases targeted
to be tested
                  Total
to reach 100%
                  (<5+>5 yr)
coverage
C. Number of
suspected         < 5 yrs
malaria (fever)
cases targeted
to be tested      > 5 yrs
to reach RBM
targets (or
national if       Total
higher)           (<5+>5 yr)
D. Available
resources for
malaria           All
diagnostic
services
FUNDING GAP
to reach RBM
targets (or
                  All
national if
higher)
(A*C) - D
Total number
of RDTs
required to
reach RBM
targets (or

                                                                        28
                                                       Malaria Consortium - RBM Country Needs Assessment Month 2008


national if
higher)

COMMODITY
GAP to reach
RBM targets
(or national if   All
higher) -
number of
RDTs
  * Calculation Tool will help with this table.




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                                               Malaria Consortium - RBM Country Needs Assessment Month 2008




5.2.2. Treatment

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status
       Management and partners’ roles
       Procurement and logistics
       Communications
       M&E
b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
         Include TA needs with estimated costs in narrative




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                                                  Malaria Consortium - RBM Country Needs Assessment Month 2008



Table 17. Treatment funding and major commodity needs to attain RBM 2010 targets (costs
in USD)
Number and cost of malaria      Age
                                           2008     2009       2010       2011      2012       2013      Total
treatments                      group
                                5-11 mo.
                                1-6 yr
Average cost per treatment*     7-13 yr
                                > 14 yr
                                Total
                                5-11 mo.
                                1-6 yr
Number of cases targeted for
                                7-13 yr
treatment
                                > 14 yr
                                Total

Available Resources             All

FUNDING GAP                     All
                    ST
Total number of 1        line
doses required
COMMODITY GAP - number
    st
of 1 line doses
* Calculation Tool will help with this table.
** Age groups should be modified based on the treatment type reported the example above includes
normal age groups for SP+AS treatment. A separate table should be provided for each treatment
type if both falciparum and non-falciparum malaria is present. These tables should be numbered
Table 17a and b.
The Calculation Tool does not provide assistance with calculating costs for 2nd line treatment
and needs for severe malaria. The reasons for this are two-fold i) estimation of needs for
these areas as transmission decreases over time is very unreliable and ii) costs will be
marginal compared to the costs for 1st line ACTs and for RDTs. Issues around 2nd line and
severe malaria can be discussed in the narrative and a 5% cost compared to that estimated
for the 1st line would be reasonable to quote as a need to cover 2nd line and severe malaria
costs. If countries or consultants would like to include more detailed costings of treatment
needs including those for 2nd line and severe malaria please include these as annex tables
with full listing of assumptions.




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                                                   Malaria Consortium - RBM Country Needs Assessment Month 2008




6. Cross-cutting issues
6.1. Epidemic/Emergency Control

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status
       Management and partners’ roles
       Procurement and logistics
       Communications
       M&E

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
        Include TA needs with estimated costs in narrative

Table 18. Epidemics and emergencies funding needs (costs in USD)
Cost to deliver malaria
emergency/epidemic           2008       2009        2010       2011        2012        2013       Total
response
Cost to deliver a malaria
response per affected
person*
Estimated number of
affected persons

Available resources for
malaria
epidemic/emergency
response
Number of affected
persons that can be
covered given available
resources

FUNDING GAP
*Unless accurate information (based on the country’s experience) is available then $12 per person should be
used. This is broken down into: $5.00 – LLIN, $2.50 – diagnosis and treatment, $1.00 – IEC, $1.50 delivery,
$2 training, supervision and monitoring, IRS cost per person covered can be the IRS calculation tool, using
cost/HH sprayed divided by av. No persons/HH.
** Notes to the table should be provided details how figures have been determined.




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                                                    Malaria Consortium - RBM Country Needs Assessment Month 2008




6.2. Advocacy/BCC/IEC

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
        Include TA needs with estimated costs in narrative

Table 19. Advocacy, IEC / BCC funding needs (costs in USD)
                         2008    2009     2010       2011                   2012        2013       Total
Costs for planned
advocacy activities
Costs for planned
BCC/IEC activities


Total estimated costs


Available resources for
advocacy

Available resources for
BCC/IEC
Total available
resources
FUNDING GAP –
advocacy
FUNDING GAP –
BCC/IEC
TOTAL FUNDING GAP
* There is no detailed calculation tool for Advocacy, IEC / BCC. Table 27 in the Annex may help to guide a
calculation of a summary cost by providing a guide of possible funding areas to be considered, using national
costing data as estimates by activity.




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                                               Malaria Consortium - RBM Country Needs Assessment Month 2008




6.3. Surveillance, Monitoring and Evaluation & Operational research

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Policies, strategies and approaches
ii. Financing
iii. Implementation status

b. Gaps and requirements
(NB. Under this section – requirements beyond commodity and delivery costs, such as human
resource/TA needs, should also be described but will be budgeted under the relevant cross cutting
sections)
i. Key bottlenecks and challenges
ii. Proposed solutions to attain 2010 targets
               Include TA needs with estimated costs in narrative




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                                                   Malaria Consortium - RBM Country Needs Assessment Month 2008



Table 20. Surveillance, monitoring & evaluation and operational Research funding needs
(costs in USD)
Monitoring and
evaluation needs
                                 2008   2009     2010        2011        2012          2013      Total
Routine surveillance
Routine Logistics
Monitoring
Supervision for above
and data utilization
Meetings for decision
making
                             1
Drug efficacy monitoring

Insecticide resistance
           2
monitoring
           3
MIS survey

Other planned surveys

                    4
Pharmacovigilance

                         5
LLIN tracking surveys

                         6
IRS quality assurance

Strengthening capacity to
enforce regulations
Equipment (computers,
GPS, PDAs etc)

Operational research

Other costs

Total estimated costs


Available resources


FUNDING GAP

* Notes below the completed table should be included to indicate source of cost estimates (e.g. national
budgets, generic estimates given below etc)
1
  Drug efficacy monitoring should be budgeted at between $30,000-$40,000 per site, per year
2
  Insecticide resistance monitoring should be budgeted at approximately $10,000 per site, per year
3
  Malaria indicator survey should be budgeted at between $400,000-$1,000,000 depending on size of country
and sample size.
4
  Pharmacovigilance should cost between $150,000 and $250,000 for start up with recurrent costs of around
50,000 per year.
5
  LLIN tracking surveys should cost between $5,000 & $8,000 depending on sample size and study area
6
  IRS quality assurance, spray operator performance, bioassays, knockdowns, window traps etc should be
costed at 25,000 – 100,000 per year depending on the number of sites and number of approaches used




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                                                Malaria Consortium - RBM Country Needs Assessment Month 2008




7. Program Management and Health Systems

7.1. Program Management and Health Systems

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. The NMCP’s mandated role
ii. NMCP decision-making authority and management
iii. NMCP enabling environment
iv. Planning, monitoring and evaluation within NMCP
v. Internal linkages and coordination within Ministry of Health
vi. Co-ordination and main roles of RBM partners at national and sub national levels

b. Gaps and requirements to allow NMCP to perform its role
i. Key bottlenecks and challenges
ii. Proposed solutions
        Include TA needs with estimated costs in narrative

Table 21. RBM partners, roles and coverage/implementation capacity and support needs

                                                      Coverage/implementation
Partner                  Role                                                        Support needs
                                                      capacity




Figure. Partnership coordination mechanism
Schematic diagram showing how coordination mechanism links to NMCP, other coordinating
mechanisms, and senior MoH personnel




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                                               Malaria Consortium - RBM Country Needs Assessment Month 2008




7.2. Supply management

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. Ministry of Health supply management systems
ii. Civil society and private sector supply management systems

b. Gaps and requirements to allow NMCP to perform its role
i. Key bottlenecks and challenges
ii. Proposed solutions
        Include TA needs with estimated costs in narrative

Figures. Schematic diagrams showing supply management systems for core interventions




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                                                       Malaria Consortium - RBM Country Needs Assessment Month 2008




7.3. Health Systems Strengthening

The narrative for each core intervention should include the subheadings given below and should
included information on all relevant issues as outlined in the GUIDELINES.

a. Situation analysis
i. The public sector health system
ii. The for-profit and not-for-profit health systems
iii. The reach of the health system
iv. Human resources: NMCP and national issues
v. Human resources: sub national and service delivery levels
vi. Human resources: initiatives to improve human resource situation


b. Gaps and requirements to strengthen the health system
i. Key bottlenecks and challenges
ii. Proposed solutions
        Include TA needs with estimated costs in narrative


Figures. NMCP and district level organograms detailing staffing norms, actual staffing levels,
and recommendations (if required) for additional positions

Table 22. Actual staffing, staffing norms and requirements

                                                                     Env.                              Comm’ty
   Region /                   Clinical Registered Nursing                       Pharma-       Lab
                 Doctors                                            Health                              Health
Province / State              officers Nurses    assistants                      cists       Techs
                                                                    Techs                              Workers

Sub national 1
Actual
Norm
Gap
Sub national 2
Actual
Norm
Gap
Sub national 3
Actual
Norm
Gap
Sub national 4
Actual
Norm
Gap
TOTAL ACTUAL
TOTAL NORMS
TOTAL GAP
* Relevant sub national levels should be inserted into the table in place of “sub national 1”, “sub national 2” etc
** It may be relevant to insert a column for population if norms are set as ratios. Giving norms and gap at total
level rather than sub-divided national is sufficient if data are not available.


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                                                                              Malaria Consortium - RBM Country Needs Assessment Month 2008




Table 23. Public Health facilities and infrastructure

                                              Health Facility                 Health Facility                 Health Facility                 Outreach
Level/Type    Hospital
                                              – level one                     – level two                     – level three                   services
              Public

                       society
                       Civil
                                 for profit
                                 Private

                                              Public

                                                       society
                                                       Civil
                                                                 for profit
                                                                 Private

                                                                              Public

                                                                                       society
                                                                                       Civil
                                                                                                 for profit
                                                                                                 Private

                                                                                                              Public

                                                                                                                       society
                                                                                                                       Civil
                                                                                                                                 for profit
                                                                                                                                 Private

                                                                                                                                              Public

                                                                                                                                                       society
                                                                                                                                                       Civil
                                                                                                                                                                 for profit
                                                                                                                                                                 Private
Actual
Norm
Gap
* Actual, Norms and Gaps for these may not exist or be known in all cases, especially for Civil
Society and PFP sectors.




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                                                                           Malaria Consortium - RBM Country Needs Assessment Month 2008


Table 24. Summary of Program Management and Institutional Strengthening funding needs
 Area                                             2008   2009       2010         2011           2012          2013          TOTAL
Institutional Strengthening
Strengthening of Training Institutes
Strengthening entomology laboratory and
insectary
Strengthening national malaria diagnostics and
quality assurance scheme
Development of training curricula pre-service
Development of training curricula in-service
Equipment
Computers
Vehicles/ Motorcycles
General; Office costs
Training General
Training of health workers on malaria and
planning its control
Community Health Workers
Training Case Management and Diagnosis
Laboratory Diagnosis for Laboratory technicians
Health workers on Case Management
Training of health workers on malaria
prevention and control
Training in Epidemics and Response
Training in IEC/BCC
RHBs Communication Sectors on material
development
Community Health Workers
Training in Database Management and Routine
Surveillance
Training in Supply Management for RHBs,
WHB, Medical Stores
Human Resources
Unspecified Technical Assistance


                                                         40
                                                                                 Malaria Consortium - RBM Country Needs Assessment Month 2008


  Area                                           2008        2009         2010         2011           2012          2013          TOTAL
 TA for assessing current M&E system (1
 international, 1 national)
 Staff Salaries
 Total estimated costs
 Available resources
 FUNDING GAP
* This is not an exhaustive list and can be modified or added to.
** Human Resources apart from training and supervision issues have not been addressed as they are part of the great health system
requirements. TA requirements are included as part of this table. Data from this table are included in the summary table, Table 11.




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                                                    Malaria Consortium - RBM Country Needs Assessment Month 2008




ANNEXES
Any more detailed tables of numbers or costings can be included here as relevant to the country

Table 25. Cost breakdown for larval control / environmental management


Larval Control and Environmental Management                     Cost ($)
Cost of Larvicide (quantity * $)
Operational Costs
Monitoring and Evaluation
IEC/BCC
Total Budget

Table 26. No. Health facilities by diagnostic method
        Facility                       Diagnostic Method
                              Microscopy    RDTs     Microscopy     Other          Total
      Type            No.                            and RDTs       (specify)      n(%)

Public
Private
CHWs
Other (Define)
Total

Table 27. Advocacy, BCC & IEC funding needs by activity (costs in USD)
ADVOCACY
                               2008        2009    2010      2011          2012       2013         Total
Development and desk
studies for campaigns
Printed material
development
Printed material
production and
distribution
Content for radio/TV
programs
Advocacy meetings
different audiences
Advocacy trainings for
specific audiences
Malaria Advocacy Group
support
Mass events
Other costs
Total estimated costs
Available resources for
Advocacy
FUNDING GAP -
Advocacy




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                                           Malaria Consortium - RBM Country Needs Assessment Month 2008




BCC/IEC

                            2008   2009   2010      2011         2012        2013         Total

ITN distribution
Printed Material
development and testing
Printed material
production and
distribution
Radio/Tv material
development and testing
Radio/Tv Material
production and
distribution

IRS
Printed Material
development and testing
Printed material
production and
distribution
Radio/Tv material
development and testing
Radio/TV Material
production and
distribution

Case Management
Printed Material
development and testing
Printed material
production and
distribution
Radio/Tv material
development and testing
Radio/Tv Material
production and
distribution

Malaria in Pregnancy
Printed Material
development and testing
Printed material
production and
distribution
Radio/Tv material
development and testing
Radio/Tv Material
production and
distribution

Other IEC/BCC
Community theatre and
other cultural activities

Community forums
Mass advertising &
marketing of messages


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                          Malaria Consortium - RBM Country Needs Assessment Month 2008




Mass events e.g. AMD

Other costs
Total estimated costs
BCC/IEC
Available resources for
BCC/IEC

FUNDING GAP BCC/IEC




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