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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.
Highlights
Documented evidence demonstrates that malaria incidences continue to decline, globally.[1]
Almost half (46.2%) of the respondents were members of the South African Malaria Elimination Committee (SAMEC), which is a technical advisory group to the National Department of Health on matters relating to malaria elimination
Congruent with El-Moamly’s6 findings, which identified vector resistance to insecticides as a potentially serious obstacle to achieving malaria elimination, this study revealed that malaria researchers were concerned about the lack of preparedness with new alternative drugs and insecticides, should resistance to current drugs and insecticides occur
Summary
Documented evidence demonstrates that malaria incidences continue to decline, globally.[1] In 2013, 198 million malaria cases and 584 000 deaths occurred, globally, translating into a decrease in mortality and case incidence by 47% and 30%, respectively, over 13 years (2000–2013).[2] SubSaharan Africa continues to bear the highest (90%) disease burden worldwide.[2] the last decade in South Africa (SA) has been hailed for substantially reducing the burden of malaria in the country.[3,4] These achievements were noted elsewhere in the world, giving rise to a new debate to target malaria elimination in countries where malaria had been substantially reduced.[5,6] South Africa, Swaziland, Namibia, and Botswana were amongst the first countries in Southern Africa to be declared by the World Health Organization (WHO) as ready to eliminate malaria.[3]. Global decline in malaria episodes over the past decade gave rise to a debate to target malaria elimination in eligible countries. Investigation regarding researchers’ perspectives on barriers and facilitating factors to effective implementation of a malaria elimination policy in South Africa (SA) is lacking
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