A research agenda for malaria eradication: health systems and operational research

malERA Consultative Group on Health Systems and Operational Research, Pedro L Alonso, Quique Bassat, David Bell, Peter Berman, Joel G Breman, Don de Savigny, Chris Drakeley, Timothy Evans, Miguel Angel González Block, Kara Hanson, Stephen Patrick Kachur, Daniel Kress, Michael Macdonald, Robert D Newman, Frank K Nyonator, Franco Pagnoni, Mark Perkins, Allan Schapira, David Schellenberg, Laurence Slutsker, David Sullivan, Marcel Tanner, Awash Teklehaimanot, Thomas Teuscher, Kamini Mendis, Graham Brown, malERA Consultative Group on Health Systems and Operational Research, Pedro L Alonso, Quique Bassat, David Bell, Peter Berman, Joel G Breman, Don de Savigny, Chris Drakeley, Timothy Evans, Miguel Angel González Block, Kara Hanson, Stephen Patrick Kachur, Daniel Kress, Michael Macdonald, Robert D Newman, Frank K Nyonator, Franco Pagnoni, Mark Perkins, Allan Schapira, David Schellenberg, Laurence Slutsker, David Sullivan, Marcel Tanner, Awash Teklehaimanot, Thomas Teuscher, Kamini Mendis, Graham Brown

Abstract

Health systems research and development is needed to support the global malaria eradication agenda. In this paper, we (the malERA Consultative Group on Health Systems and Operational Research) focus on the health systems needs of the elimination phase of malaria eradication and consider groupings of countries at different stages along the pathway to elimination. We examine the difference between the last attempt at eradication of malaria and more recent initiatives, and consider the changing health system challenges as countries make progress towards elimination. We review recent technological and theoretical developments related to health systems and the renewed commitment to strengthening health systems for universal access and greater equity. Finally, we identify a number of needs for research and development, including tools for analyzing and improving effective coverage and strengthening decision making and discuss the relevance of these needs at all levels of the health system from the community to the international level.

Conflict of interest statement

The authors have declared that they have no competing interests.

Figures

Figure 1. Health system building blocks .
Figure 1. Health system building blocks .
Image credit: Fusión Creativa.
Figure 2. Graphical representation of the systems…
Figure 2. Graphical representation of the systems effectiveness framework.
How interventions lose traction in health systems: example of artemisinin-based combination therapy (ACT) antimalarial treatment in Rufiji Demographic Surveillance Area Tanzania in 2006. Source: INDEPTH INESS Project. Systems Effectiveness Module, Swiss Tropical and Public Health Institute with data from Ifakara Health Institute and US Centers for Disease Control and Prevention based on –. Image credit: Fusión Creativa.

References

    1. Gramicci G, Beales PF. The recent history of malaria control and eradication. In: Wernsdorfer WH, McGregor SI, editors. Principles and practice of malariology. Edinburgh: Churchill Livingstone; 1988. pp. 1335–1420.
    1. Nájera JA. Malaria control: Achievements, problems and strategies. Parassitologia. 2001;43:1–89.
    1. Dowdle WR, Hopkins DR, editors. Chichester: John Wiley & Sons; 1997. The eradication of infectious diseases, Dahlem Workshop Report.
    1. WHO. Geneva: World Health Organization; 2000. World health report 2000 – Health systems: Improving performance.
    1. WHO. Geneva: World Health Organization; 2007. Everybody's business: Strengthening health systems to improve health outcomes: WHO's Framework for Action.
    1. WHO. Geneva: World Health Organization; 2008. World health report 2008 – Primary health care: More than ever.
    1. de Savigny D, Adam T. Geneva: World Health Organization; 2009. Health systems thinking for health systems strengthening.
    1. Roll Back Malaria Partnership. 2008. The Global Malaria Action Plan. For a Malaria Free World. RBM: Geneva. Available:
    1. WHO. Geneva: World Health Organization; 2009. World malaria report 2009.
    1. Bryce J, Terreri N, Victora CG, Mason E, Daelmans B, et al. Countdown to 2015: Tracking intervention coverage for child survival. Lancet. 2006;368:1067–1076.
    1. Webster J, Hill J, Lines J, Hanson K. Delivery systems for insecticide treated and untreated mosquito nets in Africa: Categorization and outcomes achieved. Health Pol Plan. 2007;22:277–293.
    1. Tanner M, de Savigny D. Malaria eradication back on the table. Bull WHO. 2008;86:82–83.
    1. Mills A, Rasheed F, Tollman S. Health system strengthening. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Alleyne G, et al., editors. Disease control priorities in developing countries, 2nd edition. New York: Oxford University Press and World Bank; 2006.
    1. Hay S, Smith D, Snow R. Measuring malaria endemicity from intense to interrupted transmission. Lancet Infect Dis. 2008;8:369–378.
    1. International Health Partnership. Leaders commit new finance to tackle women's and children's health in the developing world. 2010. Available: . 25 June 2010.
    1. Alilio MS, Bygbjerg IC, Breman JG. Are multilateral malaria research and control programs the most successful? Lessons from the past 100 years in Africa. Am J Trop Med Hyg. 2004;71:268–278.
    1. Lozano R, Soliz P, Gakidou E, Abbott-Klafter J, Feehan DM, et al. Benchmarking of performance of Mexican states with effective coverage. Lancet. 2006;368:1729–1741.
    1. INDEPTH Network Effectiveness and Safety Studies Project (INESS). Available: .
    1. Beer N, Ali AS, de Savigny D, Al-Mafazy AW, Ramsan M, et al. System effectiveness of a targeted free mass distribution of long lasting insecticidal nets in Zanzibar, Tanzania. Malar J. 2010;9:173.
    1. WHO. Geneva: World Health Organization; 2001. Commission on Macroeconomics and Health.
    1. The malERA Consultative Group on Monitoring, Evaluation, and Surveillance. A research agenda for malaria eradication: Monitoring, evaluation and surveillance. PLoS Med. 2011;8:e1000400. doi: .
    1. The malERA Consultative Group on Modeling. A research agenda for malaria eradication: Modeling. PLoS Med. 2011;8:e1000403. doi: .
    1. The malERA Consultative Group on Integration Strategies. A research agenda for malaria eradication: cross cutting issues for eradication. PLoS Med. 2011;8:e1000404. doi: .
    1. Haines A, Sanders D, Lehmann U, Rowe AK, Lawn JE, et al. Achieving child survival goals: Potential contribution of community health workers. Lancet. 2007;369:2121–2131.
    1. Staedke SG, Mwebaza N, Kamya MR, Clark TD, Dorsey G, et al. Home management of malaria with artemether-lumefantrine compared with standard care in urban Ugandan children: A randomised controlled trial. Lancet. 2009;373:1623–1631.
    1. Hetzel MW, Obrist B, Lengeler C, Msechu JJ, Nathan R, et al. Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania. BMC Public Health. 2008;8:317.
    1. Segall M. District health systems in a neoliberal world: A review of five key policy areas. Int J Health Plan Manag. 2003;18:S5–S26.
    1. Walt G. Commentary: lay health workers in primary and community health care. Int J Epidemiol. 2005;34:1251.
    1. Rowe AK, de Savigny D, Lanata CF, Victora CG. How can we achieve and maintain high-quality performance of health workers in low-resource settings? The Lancet. 2006;366:1026–1035.
    1. Rowe AK, Onikpo F, Lama M, Deming MS. The rise and fall of supervision in a project designed to strengthen supervision of Integrated Management of Childhood Illness in Benin. Health Pol Plan. 2010;25:125–134.
    1. Maestad O, Schellenberg J, Hanson K, et al. London: London School of Hygiene & Tropical Medicine; 2009. A research agenda for improving health worker performance.
    1. Goodman C, Brieger W, Unwin A, Mills A, Meek S, et al. Medicine sellers and malaria treatment in sub-Saharan Africa: What do they do and how can their practice be improved? Am J Trop Med Hyg. 2007;77:203–218.
    1. Adeyi O, Atun R. Innovating for impact: The Affordable Medicines Facility-malaria (AMFm). Nat Med. 2009;15:991.
    1. Feachem RGA The Malaria Elimination Group. San Francisco: University of California, San Francisco; 2009. Shrinking the malaria map: a guide on malaria elimination for policy makers.
    1. WHO EMRO. 2007. Malaria in Morocco: Relentless efforts towards the goal of elimination. Geneva: WHO EMRO. Available: . Accessed 25 June 2010.
    1. WHO Maximizing Positive Synergies Collaborative Group. An assessment of interactions between global health initiatives and country health systems. Lancet. 2009;373:2137–2169.
    1. WHO GMP. A field manual for low and moderate endemic countries. Geneva: World Health Organization; 2007. Malaria elimination.
    1. Service MW. Agricultural development and arthropod-borne diseases: A review. Revista de Saúde Pública. 1991;25:165–178.
    1. Birley MH, Gomes M, Davy A. Washington (D.C.): Environmental Division, World Bank; 1997. Health aspects of environmental assessment. Environmental Assessment Sourcebook Update 18.
    1. WHO. Geneva: World Health Organization; 1982. Manual on environmental management for mosquito control, with special emphasis on malaria vectors. WHO Offset Publication number 66.
    1. Peeters GK, Xuan XN, Van BW, Duc TN, Ribera JM, et al. Low perception of malaria risk among the Ra-glai ethnic minority in south-central Vietnam: Implications for forest malaria control. Malar J. 2010;9:23.
    1. Sawyer D. Economic and social consequences of malaria in new colonization projects in Brazil. Soc Sci Med. 1993;37:1131–1136.
    1. Singhanetra-Renard A. Population movement, socio-economic behavior and the transmission of malaria in northern Thailand. Southeast Asian J Trop Med Public Health. 1986;17:396–405.
    1. Rao R. New Delhi: Malaria Research Centre, India Council of Medical Research; 1984. The anophelines of India.
    1. Tanner M. Von der Tropenmedizin zur Medizin in den Tropen - Prioritäten bei der Bekämpfung übertragbarer Erkrankungen [From tropical medicine to medicine in the tropics – priorities in the control of communicable diseases]. Therapeut Umschau. 1990;47:856–863.
    1. Vlassoff C, Tanner M. The relevance of rapid assessment to health research and interventions. Health Pol Plan. 1992;7:1–9.
    1. Tugwell P, de Savigny D, Hawker G, Robinson V. Applying clinical epidemiological methods to health equity: The equity effectiveness loop. Br Med J. 2006;332:358–361.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe