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PMI Second Indoor Residual Spraying Campaign: Results of a Tour-de-Force in Logistics.

An operator, in full protective gear at midday, rinses a spraying pump after a IRS operation.(Photo USAID)

At an August 13 workshop, the Ministry of Health presented the results of the second pilot Indoor Residual Spraying (IRS) campaign in the Ouémé region. Workshop participants praised the efficiency with which all actors involved executed the campaign. They agreed unanimously that the National Malaria Control Program should carry out two additional IRS campaigns in 2010, and pursue this pilot activity in the same region until 2011 before considering scaling it up to other regions of Benin. Effective malaria prevention requires a number of interventions. One of the most effective is control of the mosquito population. The President’s Malaria Initiative (PMI) and Benin’s National Malaria Control Program (NMCP) have included spraying insecticide inside the homes—IRS—in their anti-malaria strategy. The August 13 workshop confirmed the viability of IRS in Benin’s fight against malaria. Dr. Dorothée Yevide, Director of Cabinet, representing the Minister of Health, launched the workshop following welcoming remarks by Dr. Imouro Karimou Yacoubou, National Coordinator of the National Malaria Control Program (NMCP).

Among the fifty participants attending the workshop were representatives of international, national, regional, and local health organizations involved in the fight against malaria in Benin.

The meeting was an opportunity to clarify the various stages of the IRS campaign; present entomological impact results and lessons learned of the campaign; and discuss the next steps of the IRS strategy.

Dr. Imouro Karimou Yacoubo started by recalling that, through USAID, the U.S. Government supports Benin’s five year strategic plan to fight malaria with funds from PMI. The NMCP plan includes a massive distribution of insecticide-treated mosquito bednets, fast and accurate diagnosis tools, highly effective multi-therapies based on artemisinin, preventive treatments for pregnant women, and indoor spraying of houses with insecticide. The goal is to reduce by 50 percent the number of deaths caused by malaria by the end of the year 2010.

Eugene Kiti, National IRS Coordinator at RTI, the USAID implementing partner, reported on the operational details of this logistically complex and delicate operation.

Professor Martin Akogbéto, of the Cotonou Entomological Research Center (CREC), and his assistant Mr. Gilles Padonou, presented the entomological results of the second IRS campaign. They testified that bendiocarb, the insecticide used in the IRS campaign, proved effective in reducing mosquito insecticide resistance and reducing the mortality rate due to malaria.

As for the beneficiaries, they approved almost unanimously of the IRS and its continuation. They also said that the spraying did not inconvenience them.

In her lessons learned, Dr. Colette Azandjeme, of the Departmental Directorate of Health for the Ouémé / Plateau regions, highlighted the need for greater involvement of central and local authorities and health workers, and the need to time spraying operations before the rainy season. Dr. Azandjeme advised that weekly planning of IRS operations should take into consideration economic activities such as market days and the dredging of river sand, a routine activity in the area which causes beneficiaries to be absent from their houses when IRS operations require their presence.

What is clear from the lessons learned and workshops discussions is that the sustainability of such a strategy requires also detailed planning and clock-work execution under close supervision and monitoring of each operation. This is due to myriad logistical challenges and the inherent hazards of insecticides to the health of humans, animals, and plants.

To address the sustainability of the IRS, PMI is currently recruiting through RTI one international and one local consultant to assist NMCP with developing a long-term integrated vector control (IVC) strategy. If approved by the Ministry of Health, the strategy will guide future IRS, and more broadly, IVC activities in Benin.

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