Oral Presentation First Malaria World Congress 2018

Opportunities and challenges to strengthen disease surveillance to support malaria elimination in the Philippines (#204)

Mariska HL van der Zee 1 , Inez A Medado 2 , Chris J Drakeley 1 , Fe Esperanza Caridad Jayme Espino 2 , Benjamin Palafox 1
  1. London School of Hygiene & Tropical Medicine, London, United Kingdom
  2. Research Institute for Tropical Medicine, Metro Manila, Philippines

Introduction: The Philippines aims to eliminate malaria by 2030. To accelerate towards this goal, the National Malaria Program must detect and treat all infections. However, current surveillance approaches limit the Program’s the ability to respond effectively. The country is trialing innovative diagnostic and transmission mapping techniques to improve surveillance for malaria elimination through the ENSURE project. This study evaluates the feasibility of integrating such novel techniques into the existing system.

Methods: A case study approach was used involving document review and semi-structured qualitative interviews of key informants purposefully selected from stakeholders working at all levels of the health system. Community- and provincial-level informants were selected from a project site in Occidental Mindoro. Interviews collected data on informants’ beliefs on their organisation’s readiness to integrate such novel techniques, and the various challenges and opportunities that they present, which were analysed thematically.

Results: A total of 32 interviews were conducted and 27 relevant documents reviewed. Most informants believed that integration would require considerable financial resources for equipment and training, which local and national authorities may not prioritize or be able to afford. Other common barriers included insufficient workforce, facilities’ limited internet access, and the low quality and timeliness of data reporting in certain provinces. Some mentioned that strong advocacy in support of malaria elimination could help to create an environment receptive to innovation.

Discussion: Many of the barriers to integrating the novel techniques into the existing surveillance system are general health systems issues found in other pre-elimination countries. This suggests that adopting new measures for malaria control may not proceed if such systemic barriers are left unresolved. However where affordable, opting to invest in these new techniques could catalyze strengthening of the national surveillance system, and the health system more broadly. Although, this would require advocacy to renew political support for elimination.