title: Indoor household residual spraying program performance in Matabeleland South province, Zimbabwe: 2011 to 2012; a descriptive cross-sectional study.
abstract: BACKGROUND
  Matabeleland South launched the malaria pre-elimination campaign in 2012 but provincial spraying coverage has failed to attain 95% target, with some districts still encountering malaria outbreaks. A study was conducted to evaluate program performance against achieving malaria pre-elimination.
  
  
  METHODS
  A descriptive cross sectional study was done in 5 districts carrying out IRS using the logical framework involving inputs, process, outputs and outcome evaluation. Health workers recruited into the study included direct program implementers, district and provincial program managers. An interviewer administered questionnaire, checklists, key informant interviewer guide and desk review of records were used to collect data.
  
  
  RESULTS
  We enrolled 37 primary respondents and 5 key informants. Pre-elimination, Epidemic Preparedness and Response plans were absent in all districts. Shortages of inputs were reported by 97% of respondents, with districts receiving 80% of requested budget. Insecticides were procured centrally at national level. Spraying started late and districts failed to spray all targeted households by end of December. The province is using makeshift camps with inappropriate evaporation ponds where liquid DDT waste is not safely accounted for. The provincial IHRS coverage for 2011 was 84%. Challenges cited included; food shortages for spraymen, late delivery of inputs and poor state of IHRS equipment.
  
  
  CONCLUSIONS
  The province has failed to achieve Malaria pre-elimination IRS coverage targets for 2011/12 season. Financial and logistical challenges led to delays in supply of program inputs, recruitment and training of sprayers. The Province should establish camping infrastructure with standard evaporation ponds to minimise contamination of the environment.
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Pugie Tawanda
authors.initials: PT
authors.lastname: Chimberengwa
authors.affiliation: Provincial Medical Director, Ministry of Health and Child Welfare, Matabeleland North Province, Mhlahlandlela Building, PO Box 441, Bulawayo, Zimbabwe.
authors.forename: Nyasha
authors.initials: N
authors.lastname: Masuka
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Notion Tafara
authors.initials: NT
authors.lastname: Gombe
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Mufuta
authors.initials: M
authors.lastname: Tshimanga
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Lucia
authors.initials: L
authors.lastname: Takundwa
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Donewell
authors.initials: D
authors.lastname: Bangure
mesh_terms: D000818:Animals; D003430:Cross-Sectional Studies; D017598:Efficiency, Organizational; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000592:standards; D006801:Humans; D007303:Insect Vectors / Q000187:drug effects; D007306:Insecticides / Q000627:therapeutic use*; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D009032:Mosquito Control / Q000379:methods* / Q000592:standards; D011795:Surveys and Questionnaires; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D007306:Insecticides
keywords: Matebeleland South; indoor household residual spraying; malaria; pre-elimination