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Decision-Making (DM) Tools for Malaria Control and Elimination

By Vilas Mandlekar | 05 Jun, 2017

Malaria is on the decline in many Malaria endemic countries over the past 10 years. In this context, one of the important determinants for successful administration of a malaria control and elimination program has to be the decision-making (DM) at the national, sub-national or district levels by program managers, in terms of the interventions, preventative measures, resource allocation, logistics, etc.. For this purpose, program managers need access to a wide variety of inputs (data) at the operational (field) level and at the national and sub-national levels. There are a number of health information management systems, such as the DHIS 2, that provide some of this data in the form of operational data, as well as, data dash-boards and reports.

The questions I have are: Are there DM models or tools that help malaria control program managers in identifying actions for possible outcomes, prioritizing those actions, and assessing their expected impacts. Have there been any assessments of such DM tools? DM tools need not be software-based, but could also be in the form of a set of rules or procedures.

Replies

 

William Jobin Replied at 8:18 AM, 6 Jun 2017

This is an important matter, decision-making about strategies for malaria suppression,
including provisions for flexibility at several levels.

Kitchen Sink Strategy

In the Blue Nile Health Project of Sudan, some years ago, we developed a strategy
which did not require computer simulations or complex calculations, and I think it
might not only be useful elsewhere, but also comprehensible to the average person.
The Blue Nile Health Project covered the most intensive transmission area in Sudan
and involved protection of about 2 million people for 10 years.
The (https://www.ncbi.nlm.nih.gov/pubmed/4032529) Blue Nile Health Project: a comprehensive approach to the prevention and control of water-associated (https://www.ncbi.nlm.nih.gov/pubmed/4032529) diseases in irrigated schemes of the Sudan. (https://www.ncbi.nlm.nih.gov/pubmed/4032529)
el Gaddal AA. J Trop Med Hyg. 1985 Apr;88(2):47-56.)

I think an important part of our Strategy was that our professional staff
- some dozen or so people with extensive field experience in the tools we were using -
could debate the strategy in understandable terms, not relying on some complicated
formula or data analysis.  So I hope this fits the requirements mentioned by our
colleague Vilas Mandlekar. (http://email.ghdonline.org/c/eJxlUMtqxDAM_Jr4VuNHHDsHHwplfyN4Y-3GrB_Bdhr276tQ...)

We called it the Kitchen Sink Strategy, because we used every tool available,
except the proverbial Kitchen Sink.  And we allocated funds to each tool or element
in the Strategy in proportion to our estimate of the cost-effectiveness of the element.
That part of course was subjective, but important in achieving a rational Strategy.

As we progressed with the Strategy over several years, we reached more precise
understandings of the cost-effectiveness of each element.

After about 5 years, the prevalence of malaria parasites dropped below 1%, so we again
modified our Strategy to focus on the remaining hotspots of transmission.

Bill Jobin
Former Co-Manager of Blue Nile Health Project.
William Jobin25558 Road N.6Cortez, Colorado 81321 cell fone- 1 970 317 3881email-
William Jobin25558 Road N.6Cortez, Colorado 81321 cell fone- 1 970 317 3881email-
William Jobin25558 Road N.6Cortez, Colorado 81321 cell fone- 1 970 317 3881email-

Christiana Sarfoa Replied at 12:41 PM, 6 Jun 2017

Great!

Maimunat Alex-Adeomi Moderator Replied at 3:26 PM, 6 Jun 2017

Hello all,
Thank you for an interesting discuss on DM tools for malaria control.
Please see link below of a project by Duke University's Global Health Institute on on a tool developed to help with decision analysis.
Malaria Decision Analysis Support Tool: Evaluating Health, Social and Environmental Impacts and Policy Tradeoffs

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Regards,Maimunat Maimunat. T. Alex-Adeomi

Reson Marima Replied at 4:15 PM, 6 Jun 2017

Thank you for the information.

Dinesh Koirala Replied at 7:33 AM, 17 Jun 2017

It was very informative..Thank You

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