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, Smith Gueye, Cara, Tulloch, Jim, Vilgoen, Greyling, and LEAP, (2022) Effective management of district-level malaria control and elimination: implementing quality and participative process improvements. BMC Public Health, 22. 140.

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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.

Item ID: 71394
Item Type: Article (Research - C1)
ISSN: 1471-2458
Keywords: Public health; Malaria; Health systems; Healthcare; Service delivery; Participative action research; Quality improvement
Copyright Information: © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Additional Information:

LEAP is the acronym of the Leadership and Engagement for Improved Accountability and Delivery of Services Framework Development Group

Funders: USAID PEPFAR, Bill and Melinda Gates Foundation (BMGF)
Date Deposited: 04 Feb 2022 03:13
FoR Codes: 35 COMMERCE, MANAGEMENT, TOURISM AND SERVICES > 3505 Human resources and industrial relations > 350503 Human resources management @ 60%
42 HEALTH SCIENCES > 4203 Health services and systems > 420312 Implementation science and evaluation @ 40%
SEO Codes: 20 HEALTH > 2003 Provision of health and support services > 200302 Community health care @ 60%
20 HEALTH > 2004 Public health (excl. specific population health) > 200404 Disease distribution and transmission (incl. surveillance and response) @ 40%
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