From malaria control to elimination in South Africa: The researchers’ perspectives

Abstract

BackgroundGlobal decline in malaria episodes over the past decade gave rise to a debate to target malaria elimination in eligible countries. However, investigation regarding researchers’ perspectives on barriers and facilitating factors to effective implementation of a malaria elimination policy in South Africa (SA) is lacking.AimThe aim of this study was to investigate the malaria researchers’ knowledge, understandings, perceived roles, and their perspectives on the factors influencing implementation of a malaria elimination policy in SA.SettingParticipants were drawn from the researchers who fulfilled the eligibility criteria as per the protocol, and the criteria were not setting-specific.MethodsThe study was a descriptive cross-sectional survey conducted through an emailed self-administered semi-structured questionnaire amongst malaria researchers who met the set selection criteria and signed informed consent.ResultsMost (92.3%) participants knew about SA’s malaria elimination policy, but only 45.8% had fully read it. The majority held a strong view that SA’s 2018 elimination target was not realistic, citing that the policy had neither been properly adapted to the country’s operational setting nor sufficiently disseminated to all relevant healthcare workers. Key concerns raised were lack of new tools, resources, and capacity to fight malaria; poor cross-border collaborations; overreliance on partners to implement; poor community involvement; and poor surveillance.ConclusionMalaria elimination is a noble idea, with sharp divisions. However, there is a general agreement that elimination requires: (a) strong cross-border initiatives; (b) deployment of adequate resources; (c) sustainable multistakeholder support and collaboration; (d) good surveillance systems; and (e) availability and use of all effective intervention tools.

Investigating the Resurgence of Malaria Prevalence in South Africa Between 2015 and 2018: A Scoping Review

“…A recent study by Lowe et al [56] indicated that there is a significant correlation between malaria and economic status, particularly income and housing conditions. Most researchers and stakeholders working on malaria in South Africa believe that South Africa's 2018 malaria elimination target was not realistic due to lack of new tools, resources and the capacity to fight malaria; coupled with poor cross-border collaborations; overreliance on partners to implement; poor community involvement; and poor surveillance [51,52]. Inadequate communication channels on malaria control, such as Sterile Insect Technique (SIT), also play significant roles in malaria transmission [54].…”

Investment case for malaria elimination in South Africa: a financing model for resource mobilization to accelerate regional malaria elimination

“…In South Africa for instance, a study estimated that most health workers were pessimistic that elimination targets could actually be achieved because the majority of them were not involved in the planning process. [ 30 ]. At the time of the study, no standard definition existed for population at risk of malaria at a subnational level and model-specific assumptions were required.…”

Investigating the resurgence of malaria prevalence in South Africa between 2015 and 2018: A scoping review

“…Six (25%) out of the 24 selected studies have connected malaria resurgence in South Africa with socio-economy factors [6,37,[46][47][48][49]. For instance, it has been established that migration from neighbouring countries were found to be the cause of malaria over Limpopo [6] and KwaZulu-Natal provinces [37].…”

“…For instance, it has been established that migration from neighbouring countries were found to be the cause of malaria over Limpopo [6] and KwaZulu-Natal provinces [37]. Most researchers and stakeholders working on malaria in South Africa believe that South Africa's 2018 malaria elimination target was not realistic due to lack of new tools, resources and the capacity to fight malaria; coupled with poor cross-border collaborations; overreliance on partners to implement; poor community involvement; and poor surveillance [46,47]. Inadequate communication channels on malaria control, such as Sterile Insect Technique (SIT) also play significant roles on malaria transmission [49].…”