From malaria control to elimination in South Africa: the researchers' perspectives

ABSTRACT

Background: Global decline in malaria episodes over the past decade gave rise to a debate to target malaria elimination in eligible countries. However; investigation regarding researchers' perspectives on barriers and facilitating factors to effective implementation of a malaria elimination policy in South Africa (SA) is lacking. Aim: The aim of this study was to investigate the malaria researchers' knowledge, understandings, perceived roles, and their perspectives on the factors influencing implementation of a malaria elimination policy in SA. Setting: Participants were drawn from the researchers who fulfilled the eligibility criteria as per the protocol, and the criteria were not setting-specific. Methods: The study was a descriptive cross-sectional survey conducted through an emailed self-administered semi-structured questionnaire amongst malaria researchers who met the set selection criteria and signed informed consent. Results: Most (92.3%) participants knew about SA's malaria elimination policy; but only 45.8% had fully read it. The majority held a strong view that SA's 2018 elimination target was not realistic; citing that the policy had neither been properly adapted to the country's operational setting nor sufficiently disseminated to all relevant healthcare workers. Key concerns raised were lack of new tools; resources; and capacity to fight malaria; poor cross-border collaborations; overreliance on partners to implement; poor community involvement; and poor surveillance.Conclusion: Malaria elimination is a noble idea; with sharp divisions. However; there is a general agreement that elimination requires (a) strong cross-border initiatives; (b) deployment of adequate resources; (c) sustainable multistakeholder support and collaboration; (d) good surveillance systems; and (e) availability and use of all effective intervention tools