Surveillance for Action: Operationalizing Private Sector Surveillance and Service Delivery across the Malaria Transmission Continuum.

Abstract

Despite global recommendations that surveillance systems should capture malaria case data from both private and public sectors, the integration of private sector data into national systems remains a challenge for national malaria programs in high-burden settings. The WHO's Malaria Surveillance, Monitoring & Evaluation: A Reference Manual suggests eight general guidelines for conducting private sector surveillance. Practical operational guidance is needed to implement private sector surveillance and service delivery interventions. This commentary describes available evidence and lessons learned from the Greater Mekong subregion and sub-Saharan Africa on mapping and geolocating private providers; adding private providers to national digital registries; strengthening regulation, training, and supervision; providing feedback; and subsidizing commodities. Reporting tools should be electronic, aligned or integrated with existing national systems, and adapted to meet private sector needs. A strong enabling environment is also required, including regulatory systems that mandate private providers be registered and report into national surveillance systems. Where possible, existing systems and government personnel should be used to train, supervise, and mentor private providers. Commodities such as quality-assured artemisinin combination therapies and rapid diagnostic tests need to be available to clients at affordable prices. Finally, any parallel private sector surveillance systems need to be incorporated into the Ministry of Health systems, and the Ministry of Health needs to regularly engage with the private sector. However, the private sector contains a broad spectrum of provider types and varies across countries. Strategies need to be adapted to local contexts.