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Methods for evaluating delivery systems for scaling-up malaria control intervention.

Jayne Webster1, Daniel Chandramohan, Kara Hanson

  • 1Disease Control and Vector Biology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Jayne.Webster@lshtm.ac.uk

BMC Health Services Research
|July 3, 2010
PubMed
Summary

Evaluating malaria intervention delivery systems is crucial for improving population health. A proposed framework using routine surveys can enhance evidence for optimizing malaria control strategies.

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Area of Science:

  • Public Health
  • Health Systems Research
  • Malaria Control

Background:

  • Inadequate coverage of malaria control interventions hinders progress towards national and international targets.
  • Limited understanding of optimal intervention delivery systems contributes to coverage gaps.
  • Methods for evaluating the effectiveness of different delivery systems are rarely discussed.

Purpose of the Study:

  • To review methods for evaluating delivery systems of key malaria interventions.
  • To identify inconsistencies and gaps in current evaluation methodologies.
  • To propose an improved framework for evaluating delivery system effectiveness.

Main Methods:

  • A literature review was conducted on evaluation methods for insecticide-treated nets, intermittent preventive treatment in pregnant women, and malaria treatment in children.
  • Analysis of methodologies, objectives, outcome measures, and process descriptions in existing evaluations.

Main Results:

  • Methodologies for delivery system evaluations were inconsistent, with inappropriate outcome measures and controls.
  • Delivery processes were infrequently described or measured adequately.
  • A cross-sectional observational study design is proposed for evaluating delivery systems at scale.

Conclusions:

  • The proposed evaluation framework is adaptable to large-scale natural experiments.
  • It can be implemented using data from routine surveys like Demographic and Health Surveys with minor modifications.
  • This framework can strengthen the evidence base for decisions on malaria control delivery systems and other public health interventions.