Table 5.

Midlands Year 1 challenges

Challenge	Solution	Year 1 change from baseline to endline
Treatment of confirmed malaria cases with ACTs	Supportive supervision, community training	Chirumhanzu: 7% (93% to 100%) Kwekwe: 11% (89% to 100%)
Case investigation rates	Submission of weekly disease surveillance meeting reports with action taken	Chirumhanzu: 0% (100% to 100%) Kwekwe: 19% (80% to 99%)
Poor data quality	Implemented a weekly surveillance meeting and bulletin	Improvements to data quality, completeness, and timeliness with weekly review of data in 72% of facilities in Chirumhanzu and 100% of facilities in Kwekwe
Inadequate LSM	Identify and map breeding sites, train locals on scooping and environmental modification	Chirumhanzu: 78% of sites identified and mapped (1/73 sites to 58/73 sites)
Lack of knowledge about foci management	Train EHPs, identify and map foci, conduct contact screening and treatment	2 contacts identified, screened, and treated during initiation of foci investigation activities