Malaria Elimination Ring to Interrupt Transmission (MERIT)
Malaria Elimination Ring to Interrupt Transmission (MERIT) is a precision programming model that aimed to deliver malaria control and elimination interventions targeting the communities who live in areas with the highest malaria transmission yet have limited access to malaria testing and treatment services. The model’s pilot started in 2020 in Malkangiri and Koraput districts of one of India’s highest malaria-affected states, Odisha.
The model has four pillars of core interventions to strengthen the healthcare delivery system and sharpen malaria programming at the last mile:
Integrated communitization approach for fever testing and treatment
Data-driven digital active surveillance and targeted action
Early warning and risk stratification
Health education, communication, and community mobilization.
The data triangulated from different surveys and district surveillance reports demonstrated the feasibility of strengthening system and service delivery at the most marginalized settings, promoting equity of health interventions and malaria prevention tools.
The surge capacity building through the mobilization of rapid diagnostic tests and intensive monitoring of surveillance and supply chain resulted in the increase in malaria surveillance by an estimated 13% across five most-affected districts. An estimated 46% malaria cases of the state in 2019 could be detected through the strengthened surveillance.
The health education model combining burst campaign followed by pulse communication integrated with nightly LLIN monitoring resulted in the achievement of 99.19% use rate of LLINs across targeted hamlets in 2021 against state average of use rate of 87% measured through a KAP survey in 2019. • Two of the 120 malaria Saathis have already been inducted as ASHAs in their respective villages– a model of capacity building demonstrating success.
The Doots and Saathis have achieved 39.6% annualised blood examination rate in a period of 9 months conducting 4,782 tests. 132 malaria cases were provided complete treatment in the hamlets across the period.
MERIT has been highlighted on several platforms. The Ministry of Tribal Affairs featured MERIT in their official newsletter Alekh.