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.
Highlights
The last attempt at (global) eradication of malaria, which lasted from 1955 to approximately 1969, depended on vertical operations (centrally organized activities not linked to subnational administrative levels and/or communities)
The last attempt at eradication of malaria, which lasted from 1955 to approximately 1969, depended on vertical operations
Group 1, countries that are scaling up and entering the sustained control phase, where most of the population lives in areas where malaria elimination is considered impossible with existing tools; group 2, countries with focal malaria, where a large part of the population lives in malaria-free areas, and where health systems strengthening could play a crucial role in interrupting transmission in many but not necessarily all of the existing foci
Summary
The last attempt at (global) eradication of malaria, which lasted from 1955 to approximately 1969, depended on vertical operations (centrally organized activities not linked to subnational administrative levels and/or communities). What is the costeffectiveness of different delivery modes in different national/ subnational settings (e.g., community strategy versus facility, integrated curative services versus specialized, integrated vector management) malaria vector control; operations research on effect of scale on optimal organizational structures?
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