Monitoring Is Key if Malaria Center Hopes to Receive Funds

As health workers in the provinces prepare for the coming rainy season, and the ensuing spike in malaria cases, officials at the National Malaria Center said this week that accurate reporting and careful monitoring of the disease are more important this year than ever before.

A key source of funding for the center’s projects this year is the Global Fund, which disburses its grants incrementally based on quarterly reports of the recipient’s progress.

The fund, an independent financial body supported by international donors, pledged $10 million over five years to fight malaria in Cambodia in its second round of grants. It will release $2.7 million in the next two years and will review the country’s progress at the end of the second year. If it is dissatisfied, the rest of the money will be withheld.

“If we don’t a­chieve, the Global Fund will stop,” Dr Nong Saokry, vice-director of the National Malaria Center, said Wednesday.

Regular monitoring of provincial work was a victim of the funding shortfall that plagued the center last year. In 2003, the Global Fund withheld money from its first round of grants for more than half the year, claiming that the country’s financial and monitoring systems were inadequate. As a re­sult, only a quarter of the planned re­gional supervision visits by center staff to the provinces were done according to the center’s annual report.

To prevent a similar situation this year, the center held a national training workshop March 19 and 20 for provincial malaria supervisors and financial staff on Global Fund standards of monitoring and evaluation.

Some sample questions on the health center visit checklists—such as “was the health center open when you arrived?” and “does health [center] have staff to provide malaria services at the time of visit?”—reveal the challenges of implementing the center’s programs amid the health system’s limitations.

In its annual report, the center cited the difficulty of reaching some of the most remote health centers as a primary factor in the lack of supervision visits.

In Ratanakkiri province, health workers have found alternative solutions to monitoring cases in hard-to-reach areas, provincial malaria supervisor Hoy Vannara said by telephone Wednesday. Volunteers from the village malaria worker program, first piloted in Ratanakkiri and Koh Kong pro­vinces in 2001, regularly visit 36 villages without access to a health center. The volunteers send in re­ports every three months, he said.

The first quarter of the funding round ended last month. The Ministry of Health is preparing the progress report to send to the Global Fund, said Oeurn Virak, finance officer with the ministry.

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