Policy development in malaria vector management in Mozambique, South Africa and Zimbabwe

Cliff, Julie; Lewin, Simon; Woelk, Godfrey; Fernandes, Benedita; Mariano, Alda; Sevene, Esperança; Daniels, Karen; Matinhure, Sheillah; Oxman, Andrew D; Lavis, John N.

doi:10.1093/heapol/czq008

Cited by 26 publications

(26 citation statements)

References 15 publications

(23 reference statements)

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“…For instance, legislation leading to a waiver of taxes on insecticide-treated nets and the positive impact it has had towards up-scaling of the intervention might be difficult to effect unless members of parliament are fully engaged [ 23 ]. The donor influence situation in Kenya, Tanzania and Uganda was, in this study, similar to that in Mozambique, but different from that in South Africa where the government through its department of health is known to be relatively independent in making its malaria control decisions [ 24 ]. The situation in South Africa is primarily attributed to the country’s ability to financially support its malaria control programme without having necessarily to resort to external donor funding.…”

Section: Discussionmentioning

confidence: 99%

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

Mutero

Kramer

Paul

et al. 2014

Malar J

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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.

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Section: Discussionmentioning

confidence: 99%

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

Mutero

Kramer

Paul

et al. 2014

Malar J

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“…Poor communities are dependent on vertical control measures, at least until economic improvement and other initiatives allows gradual transfer of responsibility to communities and eventually to individuals. The dialectic regarding ITNs and IRS in southern Africa has recently been summarised by Cliff et al 22 as these two methods are currently the principal strategies recommended for vector management. 23 Both seemed equally effective, costs were similar 24 and each one has a place in integrated malaria vector management.…”

Section: Discussionmentioning

confidence: 99%

Implications for health education and intervention strategies arising from children's caregivers concerns following successful malaria control

Bornman

Schlemmer²,

Walt³

et al. 2012

Transactions of the Royal Society of Tropical Medicine and Hygi

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SummaryWe investigated the interaction between social and economic circumstances with malaria awareness in rural South African villages effectively protected from malaria infection by community-passive, indoor residual spray (IRS) performed by government. We conducted interviews with 120 caregivers of children using both open-ended and closed fixed-answer questions. The mean income was between 27 and56% of the national mean, indicating a community under considerable pressure. Male parents were often absent due to work commitments. Unemployment, poverty, crime, and clean water were the main, unprompted, threats, but malaria was volunteered by none. Only when malaria was prompted (caregivers had good knowledge of malaria), did its concern rise. Malaria, therefore, was not a prominent conscious concern. This implies that alternatives to IRS that require increased community and personal engagement, behavioural changes, and time commitment (such as certain components of integrated vector management and bed nets), will 2 face implementation challenges. Unless community-passive malaria control measures can be developed that is as good or better than IRS, it seems unreasonable to expect poor communities to adopt community-active systems. Our findings should be considered in malaria control strategies, rural policy development, climate change adaptation, and communication strategies.

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“…In developing the list we applied pragmatic, but explicit criteria, for identifying concepts in a systematic, transparent, and iterative process, including involving potential end users and experts within the field. Similar methodologies have been used for managing the processes of research priorities, and policy and guideline development .…”

Section: Methodsmentioning

confidence: 99%

Key concepts that people need to understand to assess claims about treatment effects

Austvoll‐Dahlgren

Oxman

Chalmers³

et al. 2015

Journal of Evidence-Based Medicine

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Objective: People are confronted with claims about the effects of treatments and health policies daily. Our objective was to develop a list of concepts that may be important for people to understand when assessing claims about treatment effects. Methods: An initial list of concepts was generated by the project team by identifying key concepts in literature and tools written for the general public, journalists, and health professionals, and consideration of concepts related to assessing the certainty of evidence for treatment effects. We invited key researchers, journalists, teachers and others with expertise in health literacy and teaching or communicating evidence-based health care to patients to act as the project's advisory group. Results: Twenty-nine members of the advisory group provided feedback on the list of concepts and judged the list to be sufficiently complete and organised appropriately. The list includes 32 concepts divided into six groups: (i) Recognising the need for systematic reviews of fair tests, (ii) Judging whether a comparison of treatments is fair comparison, (iii) Understanding the role of chance, (iv) Considering all the relevant fair comparisons, (v) Understanding the results of fair comparisons of treatments, (vi) Judging whether fair comparisons of treatments are relevant. Conclusion:The concept list provides a starting point for developing and evaluating resources to improve people's ability to assess treatment effects. The concepts are considered to be universally relevant, and include considerations that can help people assess claims about the effects of treatments, including claims that are found in mass media reports, in advertisements and in personal communication.

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Policy development in malaria vector management in Mozambique, South Africa and Zimbabwe

Cited by 26 publications

References 15 publications

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

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

Implications for health education and intervention strategies arising from children's caregivers concerns following successful malaria control

Key concepts that people need to understand to assess claims about treatment effects

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