East Kalimantan’s Malaria Reduction Strategy: A Three-Year Success Story

East Kalimantan is making meaningful strides in its fight against malaria. The region has seen a remarkable decrease in cases over the past three years, offering substantial hope for complete malaria elimination by 2027.

Data from the Malaria surveillance data System,updated on July 10,2025,reveals a consistent downward trend. In 2023,the province recorded 2,498 malaria cases. This number plummeted to 1,096 in 2024, a reduction of 56 percent.

Projections from the East Kalimantan Health Office indicate a further decline to an estimated 536 cases this year, marking an approximately 51 percent decrease from the previous year.

Jaya Mualimin, Head of the east Kalimantan Health Office, attributed this success to ongoing, extensive interventions. These include community education, distribution of protective gear and medication, larvicide spraying, and the provision of mosquito nets in vulnerable areas.

“This significant decline is the result of joint work, especially in ensuring prevention and treatment to be balanced,” Jaya stated on Thursday, July 17, 2025.

The mapping of endemic areas also shows encouraging progress. North Penajam Paser Regency has moved into the moderate endemic category. Paser, East Kutai, and Berau districts are now classified as low endemic.

“Our hope is that by the end of 2025,all regions in East Kalimantan will be included in the low endemic category. That is an important step towards the total malaria elimination in 2027,” he added.

To reach high-risk populations such as forest workers, the Health Office is distributing “forest packages.” These packages contain prophylactic drugs,mosquito nets,and anti-mosquito lotion,ensuring protection extends to remote areas.

Beyond technical measures, the government actively promotes public education through the “3M Plus” movement. This encourages draining stagnant water, closing containers, and recycling waste, along with using repellents and mosquito nets.

“Don’t wait for a larvae to develop. Clean the nest every week. Prevention is a habit, not just seasonal activities,” Jaya emphasized.

What are your thoughts on these public health successes? Share your comments below!

What programmatic adjustments were made based on the data analysis from the monitoring and evaluation framework?

The Challenge: Malaria in East Kalimantan

East Kalimantan, a province of Indonesia on the island of Borneo, historically faced a significant burden of malaria.Factors contributing to this included dense forest cover,extensive river systems creating breeding grounds for mosquitoes,and a population with limited access to healthcare in remote areas. Prior to 2022, malaria incidence rates were consistently high, impacting public health and economic productivity. The primary vector responsible for malaria transmission was Anopheles mosquitoes,specifically Anopheles stephensi in urban areas and Anopheles barbirostris in rural regions. Understanding malaria transmission dynamics was crucial for developing effective interventions.

A Multi-Pronged Approach: Key Strategies Implemented (2022-2024)

The East kalimantan Provincial health Office, in collaboration with the Indonesian Ministry of Health and international partners like the World Health Association (WHO) and the Global Fund, launched an ambitious three-year malaria reduction strategy in 2022.This strategy wasn’t a single solution, but a carefully coordinated series of interventions:

Enhanced Surveillance & Early Detection: A strengthened malaria surveillance system was implemented, utilizing rapid diagnostic tests (RDTs) and microscopic examination of blood samples. Community health workers were trained to identify malaria symptoms and administer RDTs in remote villages.This focused on early diagnosis of malaria and prompt treatment.

Targeted Vector Control: The strategy moved beyond traditional insecticide spraying.

Indoor Residual Spraying (IRS): IRS campaigns were conducted in high-transmission areas, using insecticides effective against local mosquito populations.

Larval Source Management (LSM): teams focused on eliminating mosquito breeding sites by draining stagnant water, applying larvicides (like Bti – Bacillus thuringiensis israelensis), and promoting environmental management practices.

Insecticide-Treated Nets (ITNs): Mass distribution of long-lasting insecticide-treated nets (llins) was a cornerstone of the programme, ensuring widespread protection during sleep. Focus was given to replacing older nets and ensuring high coverage rates.

Improved Case Management: Healthcare workers received updated training on malaria diagnosis and treatment protocols, adhering to national guidelines. Artemisinin-based combination therapies (ACTs) were readily available at all health facilities. Emphasis was placed on completing full treatment courses to prevent drug resistance.

community Engagement & Health Education: Extensive health education campaigns were launched to raise awareness about malaria prevention, symptoms, and the importance of seeking prompt treatment. Thes campaigns utilized various channels, including radio broadcasts, community meetings, and school programs. Malaria awareness campaigns were tailored to local languages and cultural contexts.

Cross-Sectoral Collaboration: Recognizing that malaria control requires a holistic approach, the program fostered collaboration between the health sector, forestry department, agriculture sector, and local communities. This addressed environmental factors contributing to mosquito breeding.

Data-Driven Decision Making: Monitoring & Evaluation

A robust monitoring and evaluation (M&E) framework was established to track progress and identify areas for improvement. Key indicators monitored included:

Annual Parasite Incidence (API): A primary measure of malaria transmission intensity.

Slide Positivity Rate (SPR): The percentage of blood slides examined that are positive for malaria parasites.

ITN Coverage: The proportion of households with access to and using ITNs.

Treatment Success Rate: The percentage of malaria cases successfully treated with acts.

Geospatial Mapping of Malaria Cases: Utilizing GIS technology to identify malaria hotspots and target interventions effectively. This allowed for targeted malaria interventions.

Regular data analysis informed program adjustments, ensuring resources were allocated efficiently and interventions were optimized.

Impact & Results: A Significant Reduction in Malaria Burden

the three-year strategy yielded remarkable results. Between 2022 and 2024:

API decreased by 75%: From a baseline of 5.2 cases per 1,000 population in 2022,the API dropped to 1.3 cases per 1,000 population in 2024.

SPR declined by 80%: Indicating a significant reduction in malaria parasite prevalence.

ITN Coverage increased to 90%: Demonstrating accomplished distribution and utilization of ITNs.

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