Effective management of district-level malaria control and elimination: Implementing quality and participative process improvements

Agins, Bruce; Case, Peter; Chandramohan, Daniel; Chen, Ingrid; Chikodzore, Rudo; Chitapi, Precious; Chung, Amanda; Gosling, Roly; Gosling, Jonathan; Gumbi, Matsiliso; Ikeda, Daniel; Madinga, Munashe; Mnguni, Peliwe; Murungu, Joseph; Gueye, Cara Smith; Murungu, Joseph; Gueye, Cara Smith; Tulloch, Jim; Viljoen, Greyling

Abstract

Although it is widely recognized that strong program management is essential to achieving better health outcomes, this priority is not recognized in malaria programmatic practices. Increased management precision offers the opportunity to improve the effectiveness of malaria interventions, overcoming operational barriers to intervention coverage and accelerating the path to elimination. Here we propose a combined approach involving quality improvement, quality management, and participative process improvement, which we refer to as Combined Quality and Process Improvement (CQPI), to improve upon malaria program management. We draw on evidence from other areas of public health, as well as pilot implementation studies in Eswatini, Namibia and Zimbabwe to support the proposal. Summaries of the methodological approaches employed in the pilot studies, overview of activities and an outline of lessons learned from the implementation of CQPI are provided. Our findings suggest that a malaria management strategy that prioritizes quality and participative process improvements at the district-level can strengthen teamwork and communication while enabling the empowerment of subnational staff to solve service delivery challenges. Despite the promise of CQPI, however, policy makers and donors are not aware of its potential. Investments are therefore needed to allow CQPI to come to fruition.

• Journal Article Type: Article
• Acceptance Date: Jan 20, 2022
• Online Publication Date: Jan 20, 2022
• Publication Date: Jan 20, 2022
• Deposit Date: Feb 17, 2022
• Publicly Available Date: Feb 17, 2022
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1
• Article Number: 140
• DOI: https://doi.org/10.1186/s12889-021-12322-2
• Keywords: Public Health, Environmental and Occupational Health, Malaria, Participative Action Research, Quality Improvement
• Public URL: https://uwe-repository.worktribe.com/output/8676397
• Additional Information: Received: 4 June 2021; Accepted: 28 November 2021; First Online: 20 January 2022; : ; : No ethics approval was sought for this research in practice paper.; : Not Applicable; : No authors report any competing or conflicts of interest