Letitia Onyango

In the context of high malaria burden and insufficient resources, several national malaria programs (NMPs) used subnational tailoring (SNT) as a tool for evidence-informed decision-making on their national malaria strategic plans and funding requests. SNT is a data-informed method of developing intervention plans that maximize health impact under limited resources across heterogenous areas and populations. The SNT process included the formation of an SNT team, determination of criteria for targeting interventions, data assembly and review, stratification, application of targeting criteria to determine preliminary plans, mathematical modeling, finalization of intervention plans, and monitoring and evaluation of the eventual implemented plan, all under the leadership of the NMP. Analysis steps of SNT were supported by the World Health Organization (WHO) and other partners. As SNT was a new approach, this study used semi-structured interviews to understand the perspectives and experiences of personnel from five NMPs (Burkina Faso, Ghana, Guinea, Nigeria, and Togo) that undertook SNT between 2019 and 2023. Participants reported that SNT outputs were used to inform national strategic plans and prioritized plans, that the process incentivized improvements in data collection and data quality, and that NMPs were strongly motivated to grow their capacity to conduct more steps of the SNT analysis process internally. Major challenges included the lack of resources available to implement the full strategic plans as well as challenges with data quality and alignment of stakeholders. Participants reported a moderate to strong sense of ownership over the process and were eager to extend, adapt, and reuse the SNT process in the future. Among countries supported by WHO, SNT was well-accepted and allowed NMPs to successfully use evidence to inform their decision-making, advocate for themselves, and mobilize resources.

Background Mathematical modeling can be a useful approach to explore potential impact of malaria interventions and thereby inform resource prioritization decisions. However, expertise for applied modeling for public health decision-making is limited in malaria-endemic countries. A 4-month faculty enrichment program (FEP) in applied malaria modeling was implemented at Northwestern University, USA, in 2022 and 2023 with components including technical skills development, communication skills development, and domain knowledge on malaria epidemiology. Methods Two cohorts of FEP participants and instructors were interviewed at baseline, midline, and endline to understand their expectations, experiences, and challenges with the program. Results Participants valued their growth in technical expertise, research skills, and communication ability, as well as clear opportunities for knowledge transfer at their home institutions. Participants reported challenges with cross-disciplinary learning, balancing program components, and adapting to new teaching and learning styles. Instructors adapted program structures and teaching approaches to adjust to participant needs and reported strengthening of their own technical capacity. Conclusion Training programs for technical skill development must be informed by the needs and priorities of prospective participants and include continuous feedback mechanisms to respond to emerging needs. Multi-pronged approaches increase long-term program value to participants and help establish pathways for knowledge transfer.

In the context of high malaria burden and insufficient resources, several national malaria programs (NMPs) used subnational tailoring (SNT) as a tool for evidence-informed decision-making on their national malaria strategic plans and funding requests. The SNT process included the formation of an SNT team, determination of criteria for targeting interventions, data assembly and review, stratification, application of targeting criteria to determine preliminary plans, mathematical modeling, finalization of intervention plans, and monitoring and evaluation of the eventual implemented plan, all under the leadership of the NMP. Analysis steps of SNT were supported by the World Health Organization (WHO) and other partners. As SNT was a new approach, this study used semi-structured interviews to understand the perspectives and experiences of personnel from five NMPs (Burkina Faso, Ghana, Guinea, Nigeria, and Togo) that undertook SNT between 2019 and 2023. Participants reported that SNT outputs were used to inform national strategic plans and prioritized plans, that the process incentivized improvements in data collection and data quality, and that NMPs were strongly motivated to grow their capacity to conduct more steps of the SNT analysis process internally. Major challenges included the lack of resources available to implement the full strategic plans as well as challenges with data quality and alignment of stakeholders. Participants reported a moderate to strong sense of ownership over the process and were eager to extend, adapt, and reuse the SNT process in the future. Among countries supported by WHO, SNT was well-accepted and allowed NMPs to successfully use evidence to inform their decision-making, advocate for themselves, and mobilize resources.