Global action for training in malaria elimination

Wirth, Dyann F.; Casamitjana, Núria; Tanner, Marcel; Reich, Michael R.

doi:10.1186/s12936-018-2199-3

Cited by 24 publications

(21 citation statements)

References 6 publications

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“…There was also a lack of proper understanding of what was meant by malaria elimination among 75% of respondents. These findings point to the need to plan properly for future refresher training which is consistent with the findings from other studies [10][11][12]16].…”

Section: Discussionsupporting

confidence: 91%

“…This might possibly explain why good knowledge was attained among those trained in 2016 compared to 2017. Whatever filling the training gaps can improve the implementation of desirable actions to further scale up malaria elimination in endemic regions [16]. Health workers in the periphery usually have less exposure to malaria cases in elimination settings and therefore they require more training on case detection and foci classification as has been observed in one recent study in China [17].…”

Section: Discussionmentioning

confidence: 99%

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Do we need to go further to train healthcare providers in the targeted regions for malaria elimination in Myanmar? A mixed-methods study

Hein¹,

Maung²,

Aung³

et al. 2020

Trop Med Health

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Background: The National Malaria Control Programme (NMCP) in Myanmar trained health staff at the township level starting in mid-2016 in order to achieve the Plasmodium falciparum malaria elimination target by 2020. This study aimed to evaluate the knowledge and perception of Basic Health Staff (BHS) and Vector-borne Diseases Control (VBDC) teams exposed to a short training course on malaria elimination in six targeted townships which included two conflict-affected townships between 2016 and 2017.Methods: This was a cross-sectional mixed-methods study using quantitative and qualitative data extracted from one survey database conducted between October 2018 and March 2019. Modified Poisson regression analysis was performed to ascertain the determinants of low knowledge scores after the training programme.Results: Altogether, 544 trained frontline health workers involved in malaria elimination at the time of the survey were recruited and 56% (302/544) were stationed at sub-Rural Health Centers. More than half of the respondents had correct knowledge of malaria case categories although relapse and recrudescent cases (39% and 37% respectively) were less well known. Over two-thirds of respondents could mention those eligible for malaria testing. Less than 30% knew the foci classification. The overall knowledge scores ranged from 10 to 31. The significant predictors of low level of knowledge [the cut-off point was set at the median value of 21 (IQR 12-30)] in multivariate analysis were the younger age group (18-29 years) and health staff who had attended malaria elimination training in 2017, [(APR = 1.6, 95% CI 1.2-2.2)]; and (APR = 1.5, 95%CI 1.2-1.8)]. Qualitative data from 10 key informants identified perceived challenges in conflictaffected areas as well as in areas of high population mobility with further implications for case surveillance. In addition, the low level of education of community members was noted as one of the barriers that hampered public readiness in the elimination scenario. Conclusion: A significant impact on knowledge improvement after the training programme was not visible especially for correct notification of malaria cases and treatment according to National Malaria Elimination Guidelines. Regular monitoring and continuing guidance by the higher level management is critical to support the field staff.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Do we need to go further to train healthcare providers in the targeted regions for malaria elimination in Myanmar? A mixed-methods study

Hein¹,

Maung²,

Aung³

et al. 2020

Trop Med Health

View full text Add to dashboard Cite

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“…Which re ects a greater focus on vector control implementation compared with implementing a responsive evidence-based program that includes entomological surveillance. In fact, as countries move towards elimination, there will be a need to recruit and train more operational staff to support the intensi ed activities including vector surveillance [25]. The respondents overwhelmingly identi ed that the greatest need for sta ng and training was at the subnational and eld positions, and this is supported by previous landscaping analyses [26].…”

Section: Discussionmentioning

confidence: 76%

Capacity of National Malaria Control Programs to implement vector surveillance: A global analysis

Russell

Farlow²,

Min

et al. 2020

Preprint

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Background Solving the problem of malaria requires a highly skilled workforce with supporting infrastructure, financial backing and sound program management coordinated by a strategic plan. Here the capacity of NMCPs was analysed to identify the strengths and weaknesses underpinning implementation of vector surveillance and control activities by the core elements of program capacity, being strategic frameworks, financing, human resources, logistics and infrastructure, and information systems. Results Across nearly every country surveyed, the vector surveillance programs were hampered by a lack of capacity and capability. Only 8% of NMCPs reported having sufficient capacity to implement vector surveillance. In contrast, 57%, 56% and 28% of NMCPs had the capacity to implement LLINs, IRS and LSM activities, respectively. Largely underlying this was a lack of up-to-date strategic plans that prioritise vector surveillance and include frameworks for decision making and action. Conclusions Strategic planning and a lack of well-trained entomologists most heavily limited vector surveillance. Eliminating countries generally had more operational/field staff compared to controlling countries, and also were more likely to have an established system for staff training and capacity building. It is unlikely that controlling countries will make significant progress unless huge investments also go towards increasing the number and capacity of programmatic staff.

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“…Operational challenges, can be tackled with effective management and team work, but few district or regional health management teams have the training or skills in these topics to carry this out. 1,8 To address this problem, we developed a scalable training and mentoring program based on change management principles, participatory organization development (OD) approaches, and quality improvement (QI) methods to improve malaria elimination operational delivery at the district, clinic, and village level in three provinces of Zimbabwe. 9 10 11 12 13 14 15 16 17 The design of this program was led by UWE, with input from UCSF, drawing upon components used during an intensive, one week program for experienced managers, the majority of whom are Executive MBA students.…”

Section: Introductionmentioning

confidence: 99%

Scaling up Malaria Elimination Management and Leadership: A pilot in three provinces in Zimbabwe, 2016 -2018

Chung

Case

Gosling

et al. 2020

Preprint

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BackgroundFocus for improved malaria program performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria program effectiveness can be addressed by improving communication and coordination, increasing accountability, maintaining motivation, providing adequate training and supervision, and removing bureaucratic silos. MethodsIn collaboration with the Zimbabwe Ministry of Health and Child Care (MoHCC), University of California San Francisco (UCSF), University of West of England (UWE), Clinton Health Access Initiative (CHAI) Zimbabwe, and organization development consultants from South Africa and Zimbabwe, a program of work was piloted in Zimbabwe starting with one malaria eliminating province, Matabeleland South in 2016-2017, and scaled up to include two other provinces, Matabeleland North and Midlands, in 2017-2018. The intervention included participatory, organization development and quality improvement methods.ResultsWorkshop participants in Matabeleland South reported an improvement in data management, with the development of a data collection tool, the initiation of data reporting from district to province on a weekly basis, and the establishment of a data focal point in each district. In Matabeleland North, motivation among nurses improved as they gained confidence in case management from training, and overall staff morale was impacted positively. There was also an improvement in data quality and the frequency in which data was shared via weekly bulletins. In Midlands, the poorly performing district was motivated to improve, and both participating districts became more goal-oriented. They also became more focused on monitoring their data regularly and learned how to develop indicators to measure the process improvement changes they were making. Participants from all provinces reported having a better appreciation of the value of communication, teamwork, planning, continuous monitoring of data, and adjustment of work plans and gained skills in listening, communicating, facilitating discussions, and making presentations. Participation in the intervention changed the mindset of malaria program staff, increasing ownership and accountability, and empowering them to identify and solve problems, make decisions, and act within their sphere of influence, elevating challenges when appropriate. ConclusionsThis pilot demonstrates that a participatory, organization development and quality improvement approach has broad ranging effects, including inter alia: improving local delivery of interventions, tailoring strategies to target specific populations, finding efficiencies in the system that could not be found using the traditional top-down approach, and improving motivation and communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the program with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: a participatory, organization development and quality improvement approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.

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Global action for training in malaria elimination

Cited by 24 publications

References 6 publications

Do we need to go further to train healthcare providers in the targeted regions for malaria elimination in Myanmar? A mixed-methods study

Do we need to go further to train healthcare providers in the targeted regions for malaria elimination in Myanmar? A mixed-methods study

Capacity of National Malaria Control Programs to implement vector surveillance: A global analysis

Scaling up Malaria Elimination Management and Leadership: A pilot in three provinces in Zimbabwe, 2016 -2018

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