Abstract
Health systems underpin disease elimination and eradication programmes. In an elimination and eradication context, innovative research approaches are needed across health systems to assess readiness for programme reorientation, mitigate any decreases in effectiveness of interventions (‘effectiveness decay’), and respond to dynamic and changing needs. The malaria eradication research agenda (malERA) Refresh consultative process for the Panel on Health Systems and Policy Research identifies opportunities to build health systems evidence and the tools needed to eliminate malaria from different zones, countries, and regions and to eradicate it globally. The research questions are organised as a portfolio that global health practitioners, researchers, and funders can identify with and support. This supports the promotion of an actionable and more cohesive approach to building the evidence base for scaled-up implementation of findings. Gaps and opportunities discussed in the paper include delivery strategies to meet the changing dynamics of needs of individuals, environments, and malaria programme successes; mechanisms and approaches to best support accelerated policy and financial responsiveness at national and global level to ensure timely response to evidence and needs, including in crisis situations; and systems’ readiness tools and decision-support systems.
Highlights
IntroductionBetween 2000 and 2015, a major expansion of WHO-recommended interventions have contributed to a 58% reduction in the global malaria mortality rate (69% among children under 5 years old in Africa), resulting in an estimated 6.2 million lives being saved from a malariarelated death [1]
Between 2000 and 2015, a major expansion of WHO-recommended interventions have contributed to a 58% reduction in the global malaria mortality rate (69% among children under 5 years old in Africa), resulting in an estimated 6.2 million lives being saved from a malariarelated death [1].As part of the initial malaria eradication research agenda process, published in 2011, a consultative group on health systems and operational research established a list of research priorities presented in a matrix system organized by the different levels and building blocks of the health system [2]
This paper presents the agenda as a portfolio ranging from priorities in evaluation science to specific research questions to research and development (R&D) issues
Summary
Between 2000 and 2015, a major expansion of WHO-recommended interventions have contributed to a 58% reduction in the global malaria mortality rate (69% among children under 5 years old in Africa), resulting in an estimated 6.2 million lives being saved from a malariarelated death [1]. As part of the initial malaria eradication research agenda (malERA) process, published in 2011, a consultative group on health systems and operational research established a list of research priorities presented in a matrix system organized by the different levels (community, facility, district, and national levels) and building blocks of the health system [2]. Health-system building blocks are described in Box 1. The health systems concept and framework was based on the guiding summary on ‘health system thinking’ perspective formulated by the Alliance for Health Policy and System Research [3]. Health system building blocks that together constitute a complete system
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