Strengthening Management, Community Engagement, and Sustainability of the Subnational Response to Accelerate Malaria Elimination in Namibia

Abstract

Leadership and management skills are critical for health programs to deliver high-quality interventions in complex systems. In malaria-eliminating countries, national and subnational health teams are reorienting strategies to address focal transmission while preventing new cases and adapting to decentralization and declines in external financing. A capacity-strengthening program in two regions in Namibia helped malaria program implementers identify and address key operational, political, and financial challenges. The program focused on developing skills and techniques in problem-solving and teamwork, engaging decision-makers, and using financial evidence to prioritize domestic resources for malaria through participatory approaches. Results of the program included an observed 40% increase in malaria case reporting, 32% increase in reporting and tracing of imported malaria cases, 10% increase in malaria case management, integration of malaria activities into local operational plans, and an increase in subnational resources for malaria teams. To promote program sustainability beyond the implementation period, key program aspects were institutionalized into existing health system structures, program staff were trained in change leadership, and participants integrated the skills and approaches into their professional roles. A capacity -strengthening program with joint focus on leadership, management, and advocacy has potential for application to other health issues and geographies.

Empowering Namibia's Fight against Malaria: Drawing Inspiration from China's Remarkable Malaria Elimination Journey

“…Studies have identified factors such as cross-border transmission from neighboring countries, insecticide resistance in mosquito vectors, limited access to healthcare services in rural areas, and resource constraints as barriers to malaria control efforts in Namibia. However, there are also opportunities for strengthening malaria control, including leveraging lessons learned from other countries, enhancing collaboration and knowledge sharing, and advocating for increased political commitment and funding for malaria elimination (Chung et al, 2022). One prominent global program aimed at eliminating malaria is the "Global Malaria Programme" (GMP) initiated by the World Health Organization (WHO).…”

“…Factors such as distance to health facilities, transportation barriers, and socioeconomic factors may prevent individuals from seeking timely care. Sustaining community engagement and promoting behavior change remain essential for effective malaria control and prevention (Chung et al, 2022). Ensuring consistent use of preventive measures such as bed nets, seeking prompt treatment for fever, and adhering to treatment regimens are crucial but can be challenging to achieve.…”