Story and photos by Angela Kateemu, Communications Manager, PMI Uganda Malaria Reduction Activity
In Uganda, the threat of malaria looms large, especially for school-going children ages 6–17 years. In 2023, nearly half (45.6%)[1] of the children visiting health facilities across the country were diagnosed with malaria. Rural areas such as Karamoja bear the brunt of this epidemic.
In March 2023, recognizing the urgent need for malaria management in schools, the JSI-managed PMI Uganda Malaria Reduction Activity (PMI MRA), in collaboration with the Ministry of Health, Ministry of Education and Sports, and district malaria technical resource persons, held comprehensive two-day trainings for a total of 142 nurses and science teachers — 34 from Busoga, 20 from Karamoja, 53 from Lango, and 35 from West Nile. Facilitators, drawn from district teams and collaborating closely with local health facilities, led the trainings using the Ministry of Health curriculum. The primary aim was to give participants the knowledge and skills to manage malaria cases within their schools, including referring severe cases to nearby health facilities.
Rachael Namunhana, a school nurse at Kangole Girls Secondary School in Karamoja Region, attended the training, which provided a mix of theoretical knowledge and practical exercises focused on early detection, basic medical assessments, and the use of malaria rapid diagnostic tests. It also covered treatment options, referrals, record-keeping, and stock management. She found the training revelatory, in particular the updated treatment guidelines. “We were taken through the revised Ministry of Health treatment guidelines, which shifted my perspective on malaria management and equipped me with up-to-date methods for diagnosis and treatment.”
“During the training, we learned to identify ill children promptly, gather basic illness history, perform physical exams, and observe unusual behavior. We also acquired skills in diagnosing malaria…and deciding when to treat on-site or make urgent referrals for advanced care,” says Rachael.
Rachael’s training also led to an evolution in her approach to testing and treatment. Before training, she gave antimalarials to teachers without testing; now “I take comprehensive history, follow through with testing and treatment, and ensure complete follow-up.” Another important change was that that PMI MRA linked Rachel to the nearby Kangole Health Centre III for referring complicated cases. Previously, she referred severe malaria cases to distant hospitals, which was an additional cost and time burden for children’s families. The training also advanced Rachel’s record-keeping skills.
“I used to write only in my school book, which meant malaria information did not feature in the district picture of the malaria situation. As a result of reporting at the health center, we now regularly receive essential malaria commodities like medicines and testing kits from the facility.”
In the year since the training, Rachael has observed significant improvements in her school’s malaria management. “I ensure complete treatment adherence, prevent medicine sharing, and promote sleeping under mosquito nets.” She notes that the support from PMI MRA has reduced class absenteeism and missed treatments. “In a month, I would admit 15 children in the sick bay, due to malaria-related complications. Presently, it is 2–3 children that get admitted for complicated malaria,” she said. Rachel explained that the absenteeism was mostly due to severe malaria as a result of late diagnosis — but with the improvement in case management, there is early diagnosis and early case management, which has reduced in the number of complicated cases and admissions.
PMI MRA’s school initiative is an example of how training and capacity building improve health outcomes and school attendance, contributing to students’ overall well-being and educational success.
“I maintain detailed registers to follow up with students in their classes, ensuring they complete their prescribed medication. I particularly appreciate the focus on the latest malaria diagnostic techniques and treatment guidelines,” Rachael adds. “Understanding these distinctions has been critical in ensuring that I provide the best possible care to our students.”
[1] DHIS2 2023.
