Factors influencing malaria control policy-making in Kenya, Uganda and Tanzania

Abstract

BackgroundPolicy decisions for malaria control are often difficult to make as decision-makers have to carefully consider an array of options and respond to the needs of a large number of stakeholders. This study assessed the factors and specific objectives that influence malaria control policy decisions, as a crucial first step towards developing an inclusive malaria decision analysis support tool (MDAST).MethodsCountry-specific stakeholder engagement activities using structured questionnaires were carried out in Kenya, Uganda and Tanzania. The survey respondents were drawn from a non-random purposeful sample of stakeholders, targeting individuals in ministries and non-governmental organizations whose policy decisions and actions are likely to have an impact on the status of malaria. Summary statistics across the three countries are presented in aggregate.ResultsImportant findings aggregated across countries included a belief that donor preferences and agendas were exerting too much influence on malaria policies in the countries. Respondents on average also thought that some relevant objectives such as engaging members of parliament by the agency responsible for malaria control in a particular country were not being given enough consideration in malaria decision-making. Factors found to influence decisions regarding specific malaria control strategies included donor agendas, costs, effectiveness of interventions, health and environmental impacts, compliance and/acceptance, financial sustainability, and vector resistance to insecticides.ConclusionMalaria control decision-makers in Kenya, Uganda and Tanzania take into account health and environmental impacts as well as cost implications of different intervention strategies. Further engagement of government legislators and other policy makers is needed in order to increase funding from domestic sources, reduce donor dependence, sustain interventions and consolidate current gains in malaria.

Pyrethroid and DDT Resistance and Organophosphate Susceptibility amongAnophelesspp. Mosquitoes, Western Kenya

“…This finding has critical implications in guiding malaria vector control in Kenya. In Kenya, current policy on IRS use of insecticides is limited to pyrethroids and DDT ( 13 ). Considering widespread pyrethroid resistance, non–pyrethroid-based vector control tools may be preferable.…”

National malaria vector control policy: an analysis of the decision to scale-up larviciding in Nigeria

“…2013 ), malaria control including vector control ( Woelk et al. 2009 ; Mutero et al . 2014 ) malaria vector control ( Cliff et al .…”

Identifying barriers in the malaria control policymaking process in East Africa: insights from stakeholders and a structured literature review

“…Overall financial resources are a major determinant in decision making, according to data from the survey and workshops, which primarily is a stage three barrier to implementation. The survey also indicated a greater need for research to inform the policy process, and a desire for a less politically-driven agenda in the malaria control process [ 13 ]. The survey results were echoed in comments during the discussion in the stakeholder workshops.…”

“…As an additional part of the development of MDAST, malaria policy stakeholders from Kenya, Tanzania, and Uganda participated in a survey and workshops in July and August 2010 on malaria policymaking activities in their country [ 13 ]. The survey respondents were drawn from a non-random purposeful sample of key stakeholders selected by lead MDAST project collaborators in each country (Division of Malaria Control in Kenya, Vector Control Division in Uganda, and the National Institute for Medical Research in Tanzania).…”