Sub-national tailoring of malaria interventions in Mozambique

Malaria remains a public health problem in Mozambique, with more than 10 million cases confirmed in 2020 (WHO Malaria Report 2020).

The Mozambique National Malaria Control Program (NMCP) leads the fight against malaria in the country through the development and implementation of National Strategic Plans (NSP). The NSP defines the NMCP strategies for fighting malaria including the interventions selected (i.e. bed nets, insecticide spraying, drug based interventions etc.) and their distribution in the country. NSPs are regularly updated and reviewed i.e. during the Malaria Program Review (MPR). NSPs form the base for funding request to international donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The Analytics and Intervention Modelling group (AIM) provides model-based evidence to support the development and review of the NSP and the application for the Global Fund funding requests in Mozambique. The support to the Mozambique NMCP started in 2019 as part of the “High Burden to High Impact” (HBHI) initiative launched by the World Health Organization (WHO). Since then, the AIM group has continued providing technical support to the NMCP including during the 2022 MPR. The objective of our work is to use results from mathematical modelling to inform decision-making processes. In particular, modelling provided in-country evidence to inform the choice of control strategies. The process is briefly summarised below.

• We collate epidemiological data of the country and receive directly from the NMCP alternative plans for the distribution of interventions in the form of scenarios.
• We then calibrate the mathematical model developed in-house in order to represent the current situation in the country.
• We are then able to analyse the different scenarios to determine their impact in reducing malaria trasmission.
  
• The combination of interventions is then refined to develop the most effective combination of interventions, also called stratification.

Strong engagement with the NMCP is essential to drive the defining of objectives, sharing of data and definition of the scenarios. This is possible thanks to in-country partners such as local staff of the Clinton Health Access Initiative (CHAI).

The work is funded by the Bill and Melinda Gates Foundation (BMGF).

An initial summary of the results was presented during the annual meeting of the American Society for Tropical Medicine and Hygiene (ASTMH) in 2020.

The team is also able to provide evidence based support to specific advocacy requests of the NMCP using mathematical modelling. Some example are provided in the bed net distribution analyses and mass drug administration (MDA) deployment analyses for the North of the Mozambique as an emergency response to conflicts.

Involved Regions: Africa
Involved Countries: Mozambique