For more than 12 years, Mwanzarimwabo Innocent has been the heartbeat of Mataba village in the Rwaza sector. Located in Rwanda’s Musanze District in the Northern Province of the country, Musanze is the country’s most mountainous district, and its terrain makes health care access challenging at times. As a dedicated community health worker (CHW), Innocent has supported his neighbours through challenges and triumphs, ensuring that every family has access to malaria prevention and control services close to home.
Throughout his service, one responsibility has always defined his role: being the first line of defence against malaria, an illness caused by parasites spread through mosquito bites, causing fever, chills, and fatigue. This severe illness continues to affect families across the region. In Rwanda, CHWs like Innocent are the primary frontline force, as they treat 60% of all uncomplicated malaria cases in the country.
In 2025, malaria affected about 94 out of every 1,000 people, based on data from the country’s health reporting system. In the Musanze District, 14,741 people were diagnosed with malaria out of a population of 510,164. The district includes two high-burden sectors, one of which is Innocent’s region. Rwaza reported significantly elevated incidence rates of 124 cases of malaria per 1,000 people.
In November 2025, Innocent joined fellow CHWs for a district-wide training organized through the Unitaid-funded Scaling the Optimal Use of Multiple Artemisinin-Based Combination Therapy to Prevent Antimalarial Drug Resistance (STOP-AMDR) project. Implemented by Jhpiego in collaboration with the Malaria and Other Parasitic Diseases Division/Rwanda Biomedical Centre (MOPDD/RBC), this project aims to strengthen frontline malaria care.
During the training, Innocent and his fellow CHWs discussed local malaria trends and challenges, refreshed their skills in malaria diagnosis using rapid diagnostic tests (RDTs), and learned how to effectively administer Artesunate/Pyronaridine (ASPY), a new treatment used to manage uncomplicated malaria cases. More than 1,600 CHWs in the Musanze District completed the training, representing 94.4% of the health workers who were asked to participate.
This training is a key component of Rwanda’s Multiple First Line Treatment (MFT) Strategy, an approach designed to slow the spread of antimalarial drug resistance by rotating three different malaria treatments across designated district blocks each year. Under this strategy, Rwanda is using multiple antimalarial drugs, including ASPY, Dihydroartemisinin-piperaquine (DHAP), and Artemether Lumefantrine (AL), the latter being the standard treatment for uncomplicated malaria for nearly 20 years. Following its recent introduction in early 2025, Musanze District is using ASPY this year as part of the treatment rotation.
To successfully implement the MFT strategy, Rwanda organized its districts into three blocks, with each block assigned to one of the three malaria drugs: ASPY, DHAP, or AL. Each block will use one assigned treatment for a full year, after which the treatments rotate. This rotation model is more effective in deterring and reducing the risk of antimalarial drug resistance by ensuring no single treatment is used continuously.
For Innocent, the training was transformative. He strengthened his skills around rapid diagnostic tests and learned how to follow Rwanda’s updated ASPY treatment guidelines. Today, he feels fully equipped to diagnose and treat malaria quickly and safely at the community level, where rapid action matters most.
Not long after the training, Innocent’s new skills were put to the test. A mother called him in panic; her seven-year-old daughter was burning with a high fever. Innocent arrived quickly and performed a rapid diagnostic test, which confirmed that the child had malaria. He immediately administered ASPY and counselled the mother on what symptoms to monitor and when to seek care. Within two days, the child’s fever was gone. By day three, the little girl was back in school, smiling, energetic, and healthy. For Innocent, this moment was powerful proof of what confidence, knowledge, and timely support can achieve.
“This training changed how we fight malaria…with RDTs and ASPY, we treat faster and help protect our medicines from resistance,” said Mwanzarimwabo Innocent.
Today, Innocent walks through his community with renewed confidence. Thanks to STOP-AMDR and its committed partners, CHWs like Innocent are now equipped with the tools, knowledge, and confidence to stop malaria where it strikes first—at the community level. Their renewed capacity is helping protect families, strengthen communities, and contribute to the country’s efforts to reduce the malaria burden by staying ahead of drug resistance.
Albertine Sisulu Kajyambere is the Communications Advisor for Jhpiego Rwanda; Jean Modeste Harerimana is a Senior Malaria Advisor; Marcel Manariyo is a Senior Monitoring, Evaluation, and Learning Advisor; and Noella Umulisa is Jhpiego's Project Director for STOP-AMDR in Rwanda.
Gladys Tetteh is Jhpiego's Senior Technical Director for Malaria.
