How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo
Abstract Background Declining malaria prevalence and pressure on external funding have increased the need for efficiency in malaria control in sub-Saharan Africa (SSA). Modelled Plasmodium falciparum parasite rate (PfPR) maps are increasingly becoming available and provide information on the epidemi...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-020-03425-z |
| _version_ | 1819007159489265664 |
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| author | Ludovica Ghilardi George Okello Linda Nyondo-Mipando Chawanangwa Mahebere Chirambo Fathy Malongo Jenna Hoyt Jieun Lee Yovitha Sedekia Justin Parkhurst Jo Lines Robert W. Snow Caroline A. Lynch Jayne Webster |
| author_facet | Ludovica Ghilardi George Okello Linda Nyondo-Mipando Chawanangwa Mahebere Chirambo Fathy Malongo Jenna Hoyt Jieun Lee Yovitha Sedekia Justin Parkhurst Jo Lines Robert W. Snow Caroline A. Lynch Jayne Webster |
| author_sort | Ludovica Ghilardi |
| collection | DOAJ |
| description | Abstract Background Declining malaria prevalence and pressure on external funding have increased the need for efficiency in malaria control in sub-Saharan Africa (SSA). Modelled Plasmodium falciparum parasite rate (PfPR) maps are increasingly becoming available and provide information on the epidemiological situation of countries. However, how these maps are understood or used for national malaria planning is rarely explored. In this study, the practices and perceptions of national decision-makers on the utility of malaria risk maps, showing prevalence of parasitaemia or incidence of illness, was investigated. Methods A document review of recent National Malaria Strategic Plans was combined with 64 in-depth interviews with stakeholders in Kenya, Malawi and the Democratic Republic of Congo (DRC). The document review focused on the type of epidemiological maps included and their use in prioritising and targeting interventions. Interviews (14 Kenya, 17 Malawi, 27 DRC, 6 global level) explored drivers of stakeholder perceptions of the utility, value and limitations of malaria risk maps. Results Three different types of maps were used to show malaria epidemiological strata: malaria prevalence using a PfPR modelled map (Kenya); malaria incidence using routine health system data (Malawi); and malaria prevalence using data from the most recent Demographic and Health Survey (DRC). In Kenya the map was used to target preventative interventions, including long-lasting insecticide-treated nets (LLINs) and intermittent preventive treatment in pregnancy (IPTp), whilst in Malawi and DRC the maps were used to target in-door residual spraying (IRS) and LLINs distributions in schools. Maps were also used for operational planning, supply quantification, financial justification and advocacy. Findings from the interviews suggested that decision-makers lacked trust in the modelled PfPR maps when based on only a few empirical data points (Malawi and DRC). Conclusions Maps were generally used to identify areas with high prevalence in order to implement specific interventions. Despite the availability of national level modelled PfPR maps in all three countries, they were only used in one country. Perceived utility of malaria risk maps was associated with the epidemiological structure of the country and use was driven by perceived need, understanding (quality and relevance), ownership and trust in the data used to develop the maps. |
| first_indexed | 2024-12-21T00:20:09Z |
| format | Article |
| id | doaj.art-56265134176342bdb96f162130be0abb |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-21T00:20:09Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-56265134176342bdb96f162130be0abb2022-12-21T19:22:07ZengBMCMalaria Journal1475-28752020-10-0119111710.1186/s12936-020-03425-zHow useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of CongoLudovica Ghilardi0George Okello1Linda Nyondo-Mipando2Chawanangwa Mahebere Chirambo3Fathy Malongo4Jenna Hoyt5Jieun Lee6Yovitha Sedekia7Justin Parkhurst8Jo Lines9Robert W. Snow10Caroline A. Lynch11Jayne Webster12Department of Disease Control, London School of Hygiene and Tropical MedicineKenya Medical Research Institute-Wellcome Trust Research ProgrammeDepartment of Health Systems and Policy, College of Medicine, University of MalawiDepartment of Health Systems and Policy, College of Medicine, University of MalawiKinshasa School of Public Health, University of Kinshasa, Mont Amba/LembaDepartment of Disease Control, London School of Hygiene and Tropical MedicineWorld Vision UKMwanza Intervention Trials Unit (MITU)/ National Institute for Medical Research (NIMR)- Mwanza Research CentreLondon School of Economics and Political ScienceDepartment of Disease Control, London School of Hygiene and Tropical MedicineKenya Medical Research Institute-Wellcome Trust Research ProgrammeDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineDepartment of Disease Control, London School of Hygiene and Tropical MedicineAbstract Background Declining malaria prevalence and pressure on external funding have increased the need for efficiency in malaria control in sub-Saharan Africa (SSA). Modelled Plasmodium falciparum parasite rate (PfPR) maps are increasingly becoming available and provide information on the epidemiological situation of countries. However, how these maps are understood or used for national malaria planning is rarely explored. In this study, the practices and perceptions of national decision-makers on the utility of malaria risk maps, showing prevalence of parasitaemia or incidence of illness, was investigated. Methods A document review of recent National Malaria Strategic Plans was combined with 64 in-depth interviews with stakeholders in Kenya, Malawi and the Democratic Republic of Congo (DRC). The document review focused on the type of epidemiological maps included and their use in prioritising and targeting interventions. Interviews (14 Kenya, 17 Malawi, 27 DRC, 6 global level) explored drivers of stakeholder perceptions of the utility, value and limitations of malaria risk maps. Results Three different types of maps were used to show malaria epidemiological strata: malaria prevalence using a PfPR modelled map (Kenya); malaria incidence using routine health system data (Malawi); and malaria prevalence using data from the most recent Demographic and Health Survey (DRC). In Kenya the map was used to target preventative interventions, including long-lasting insecticide-treated nets (LLINs) and intermittent preventive treatment in pregnancy (IPTp), whilst in Malawi and DRC the maps were used to target in-door residual spraying (IRS) and LLINs distributions in schools. Maps were also used for operational planning, supply quantification, financial justification and advocacy. Findings from the interviews suggested that decision-makers lacked trust in the modelled PfPR maps when based on only a few empirical data points (Malawi and DRC). Conclusions Maps were generally used to identify areas with high prevalence in order to implement specific interventions. Despite the availability of national level modelled PfPR maps in all three countries, they were only used in one country. Perceived utility of malaria risk maps was associated with the epidemiological structure of the country and use was driven by perceived need, understanding (quality and relevance), ownership and trust in the data used to develop the maps.http://link.springer.com/article/10.1186/s12936-020-03425-zRisk mapsModelled PfPR mapsTargetingNational Malaria Control ProgrammeKenyaMalawi |
| spellingShingle | Ludovica Ghilardi George Okello Linda Nyondo-Mipando Chawanangwa Mahebere Chirambo Fathy Malongo Jenna Hoyt Jieun Lee Yovitha Sedekia Justin Parkhurst Jo Lines Robert W. Snow Caroline A. Lynch Jayne Webster How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo Malaria Journal Risk maps Modelled PfPR maps Targeting National Malaria Control Programme Kenya Malawi |
| title | How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo |
| title_full | How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo |
| title_fullStr | How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo |
| title_full_unstemmed | How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo |
| title_short | How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo |
| title_sort | how useful are malaria risk maps at the country level perceptions of decision makers in kenya malawi and the democratic republic of congo |
| topic | Risk maps Modelled PfPR maps Targeting National Malaria Control Programme Kenya Malawi |
| url | http://link.springer.com/article/10.1186/s12936-020-03425-z |
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