Strengthening PHC to Manage Malaria in Iran

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Strengthening PHC to Manage Malaria in Iran

• The Behvarz experience
• Dr A. Raesisi
• MPH Epidemiologist
• National Malaria Control Programme Manager

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Malaria control activities have been integrated
in the PHC since 1988 .
At present there are 16040 Health House run by
two community Health Workers ( Behvarz ) , One
male and one female .
Around 1000 population are covered by one H.H.
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The following Health activities are delivered
by the Health House
- M C H
- Immunization
- Prenatal care and Family Planning
- Environmental Health
- Control of Endemic Diseases
- Other Standard Case Management .
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In the areas with high Malaria Transmission
Implementation of the malaria control activities
are the main responsibility of the Behvarz .
At the village level all cases suffering from
Malaria symptom are referred to the Health House
for blood slide taking and also receiving
antimalaria drugs .
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Usually the blood slides , in particular for
the passive cases, are sent to the nearest Rural
Health Center on the same day .
80 of all slides are examined and will
receive the treatment according to available
guideline in less than 24 hours .
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The Vivax cases will have monthly blood slides
taken by the Behvarz.
Three days after starting the treatment of
falciparum cases , one slide will be taken by
the Behvarz . Followed by weekly slides up to
one month after the treatment .
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The insecticide operation is carried out under
the Behvarz supervision .
In those areas which are not covered by PHC the
antimalaria activities are carried by mobile
teams .
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The great majority of the areas not covered by
PHC are located in the three South - east
provinces , namely Sistan Baluchestan ,
Hormozgan and Kerman which report 60 of total
malaria cases .
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Despite the low coverage of the PHC in the
above mentioned areas the experiences have shown
that the establishment of very small passive
posts in addition to mobile teams improved the
early detection treatment of malaria cases .
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