Factors influencing malaria control policy-making in Kenya, Uganda and Tanzania

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• 作者：Clifford M Mutero (11) (12)
  Randall A Kramer (13) (14)
  Christopher Paul (13) (14)
  Adriane Lesser (14)
  Marie Lynn Miranda (15)
  Leonard EG Mboera (16)
  Rebecca Kiptui (17)
  Narcis Kabatereine (18)
  Birkinesh Ameneshewa (19)
  
  11. Centre for Sustainable Malaria Control and School of Health Systems and Public Health ; University of Pretoria ; Private Bag 323 ; Pretoria ; 0001 ; South Africa
  12. International Centre of Insect Physiology and Ecology ; P.O. Box 30772 ; Nairobi ; Kenya
  13. Nicholas School of the Environment ; Duke University ; 9 Circuit Drive ; Durham ; NC ; 27708 ; USA
  14. Duke Global Health Institute ; Duke University ; 310 Trent Drive ; Durham ; NC ; 27710 ; USA
  15. School of Natural Resources and Environment ; University of Michigan ; 440 Church Street ; Ann Arbor ; MI ; 48109 ; USA
  16. National Institute for Medical Research ; 2448 Barack Obama Drive ; Dar es Salaam ; P.O. Box 9653 ; Tanzania
  17. Division of Malaria Control ; Ministry of Health ; P.O. Box 20750 ; Nairobi ; Kenya
  18. Vector Control Division ; Ministry of Health ; Kampala ; P.O. Box 1661 ; Uganda
  19. WHO Regional Office for Africa ; P.O. Box 06 ; Brazzaville ; Congo Republic
  
• 关键词：Malaria ; Policy makers ; Decision ; analysis tools ; MDAST ; Multi ; sectoral approach
• 刊名：Malaria Journal
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：13
• 期：1
• 全文大小：5,765 KB
• 参考文献：World Malaria Report. World Health Organization, Geneva
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• 刊物主题：Parasitology; Infectious Diseases; Tropical Medicine;
• 出版者：BioMed Central
• ISSN：1475-2875

文摘

Background Policy decisions for malaria control are often difficult to make as decision-makers have to carefully consider an array of options and respond to the needs of a large number of stakeholders. This study assessed the factors and specific objectives that influence malaria control policy decisions, as a crucial first step towards developing an inclusive malaria decision analysis support tool (MDAST). Methods Country-specific stakeholder engagement activities using structured questionnaires were carried out in Kenya, Uganda and Tanzania. The survey respondents were drawn from a non-random purposeful sample of stakeholders, targeting individuals in ministries and non-governmental organizations whose policy decisions and actions are likely to have an impact on the status of malaria. Summary statistics across the three countries are presented in aggregate. Results Important findings aggregated across countries included a belief that donor preferences and agendas were exerting too much influence on malaria policies in the countries. Respondents on average also thought that some relevant objectives such as engaging members of parliament by the agency responsible for malaria control in a particular country were not being given enough consideration in malaria decision-making. Factors found to influence decisions regarding specific malaria control strategies included donor agendas, costs, effectiveness of interventions, health and environmental impacts, compliance and/acceptance, financial sustainability, and vector resistance to insecticides. Conclusion Malaria control decision-makers in Kenya, Uganda and Tanzania take into account health and environmental impacts as well as cost implications of different intervention strategies. Further engagement of government legislators and other policy makers is needed in order to increase funding from domestic sources, reduce donor dependence, sustain interventions and consolidate current gains in malaria.