MALARIA ELIMINATION IN ZANZIBAR - Soper Strategies

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PROGRAM MANAGEMENT: FROM ZMCP TO ZMEP
“He should have the quality of LEADERSHIP, because
during a number of years he will be the chief of an army that
must win a difficult war. He needs COURAGE, because
he must dare to recognize the faults of his organization,
to correct his mistakes, to dismiss the wrong men, to
face unpopularity and to fight continuously against the
lukewarm, if not definitely cold, attitude of a number of
officials whose routine administrative habits are disrupted
by his request for punctuality, and who sometimes happen
to be superior in rank, and/or may have a say as regards to
his future position when eradication is complete. He must
have FAITH, because a number of influential people in his
country think they know better and will look at the program
as at an unrealistic, extravagant and costly enterprise; and
because if he has not faith in the success he will not be
able to inspire his staff, to stimulate them to sustain those
efforts and hardships that are their lot. He must show
PERSISTENCE, because it is only too likely that during all
the 8 or more years of the malaria eradication program, new
problems will arise, trained men will leave, the cooperation
of the population will deteriorate, the enthusiasm of his
own staff will gradually disappear; while that degree of
the perfect of the work, necessary for success, must always
be maintained during all those long years. To those four
virtues must be added the ABILITY TO ESTABLISH
GOOD RELATIONSHIPS with the critics and dissenters.”
–Emilio Pampana, 1969, on the qualities of a Director of
a National Eradication Program.
INTRODUCTION
FIGURE 24: ZMCP ORGANIZATIONAL CHART
When moving towards elimination, the ZMCP will be faced
with different requirements related to the administration of the
national program. Today, the ZMCP has sufficient capacity to
implement the control interventions specified in their national
strategy. However, the shift in focus from the classical control
measures, such as the distribution of impregnated mosquito nets
and ACTs, to more intensive surveillance will require a shift in
competencies and capacity within the program. An important
difference from control as illustrated by Emilio Pampana’s
quote lies in the program leadership required. In addition, the
program will need to be provided with the necessary tools and
competencies to implement a far more complicated M&E system.
This chapter compares the current capacity of the ZMCP with
the requirements for an elimination program and identifies gaps
in terms of human resources, equipment and infrastructure that
will need to be addressed before embarking on elimination.
STRUCTURE AND RESPONSIBILITIES OF THE ZMCP
The ZMCP is responsible for the coordination of all malaria
activities on Zanzibar. It is a sub-Unit of the Directorate of
Preventive Services and Health Education of the Ministry of
Health and Social Welfare. The latter are the principle recipient
of the Global Fund grants but the day-to-day management of
the grants has been delegated to the ZMCP. The set-up of the
ZMCP can be seen in the organizational chart below (Figure 24).