1. Unit 10 PREPARING A PLAN FOR MALARIA ELIMINATION

2. Learning objectives By the end of this Unit, the participants should be able to: ●Explain what planning is and state its relevance to malaria prevention, control, and elimination ●Describe the planning process and cycle ●Identify the characteristics of the planning environment and take them into account when planning ●Write a preliminary plan for malaria elimination ●Select a set of indicators and formulate a plan for monitoring and evaluation of a malaria elimination programme.

3. The purposes of health planning ●Improve the health status of the population ●Use the available and future resources in a cost-effective way ●Coordinate efforts and actions by all stakeholders ●Avoid duplication of activities ●Seek donor funding ?

4. Health planning Based on an understanding of : ○People as beneficiaries ○Environment ○Health service delivery systems

5. Social–economic determinants of malaria ●Demography ●Poverty ●Education: knowledge of the disease, prevention and treatment is crucial factor that affect its transmission ●Living conditions: resident of rural areas, bad housing, lack of electricity ●Livelihood : certain Occupations affect people’s behavior. agriculture, forest workers ●Immigration/conflict : Refugees, migrants, displaced Mobility : nomadic populations, travelers to endemic areas ●Cultural : sleeping patters ●Border population : border areas and access

6. Environment ●Geographic features ( desert, plain, altitude… ●Meteorological data ( temp. rain … ●Water management systems, agricultural projects, irrigation systems,

7. What is planning ? ●analysing problems ●prediction of the effects of future activities on the present situation, ●making choices among alternatives, examining solutions, ●setting priorities, ●making decisions, ●developing strategies, ●setting objective and focus on its achievement. ●allocating resources

8. Malaria Problem or Statement ●History, changing trend, past epidemics ●Past, current control activities ●History of elimination attempts ●Current malaria epidemiology ●Stratification, risk mapping ●Inventory of foci and classification

9. Better representation ● use graph, charts, maps ● Can the malaria problem(s) be described as problem trees? ● malaria country profile malaria country profile

10. Malaria elimination - Feasibility analysis ● Conduct a feasibility analysis ( Technical, Operational, Economic.. ● Assess opportunities Subr-regional initiatives, interrelationships with neighbouring countries Others, Global renewed commitment, regional resolutions,

11.  1998 : adopted a resolution ( EM/RC45/R.3) to support malaria elimination efforts in areas where it was feasible  2008: EMR adopted a resolution ( EM/RC 55/R.9 supporting the vision of malaria elimination from EMR 11 Commitments to malaria elimination WHO EMR

12. Planning elimination in area (s) where this is feasible ●Tentatively set up timelines ●Plan interventions required to achieve elimination within these timelines ●Consider option of species elimination (Phased approach) ●If necessary coordinate with malaria control activities in non-elimination zones

13. The planning process logical framework ●ultimate goal. ●well-defined objectives ●Set activities with targets and fixed dates for their implementation ●Address questions  What is the situation now?  What is the desirable situation?  How will this situation be reached?  What interventions, why, where, when, who  How will success be identified?

14. I KEEP six honest serving-men (They taught me all I knew); Their names are What and Why and When and How and Where and Who. I send them over land and sea, I send them east and west; But after they have worked for me, I give them all a rest.

15. Apply GPP (good planning practice) ●Define input, outputs, outcomes (targets), impact objectives ●SMART objectives and targets (specific, measurable achievable, realistic and timebound ●Define indicators ●When linking out puts to outcomes, and outcomes to objectives, make the assumptions clear ●Prioritize, coordinate, find opportunities, threats, risks (SWOT)

17. The planning environment ●Malaria plan should be developed on technical basis ●A political process.  Health policies are generally defined at the ministerial level. Higher level interpret the policies and develop a national plan.  Lower level have administrative responsibility for implementation of the national plan is to develop an implementation plan and supervise its achievement at the local level.

18. The planning period ●A plan for a malaria programme will be part of the overall national health programme and therefore the period of planning should normally correspond to that of the national health plan. ●The overall planning period should be realistic and long enough to allow a real impact on population health (=>5 years). ●Implementation of the plan should focus on a shorter period, usually one year, for reaching the operational targets that have been set in the plan.

19. Try to Overcome the Obstacles ●Provision of planned resources does not always follow. ●Decision-makers at a high-level do not support due to poor awareness or political decisions ●Timely delivery of medicines and other commodities is not assured. ●The necessary logistics for programme implementation, field studies, and for supervision ●Lack of expertise in planning within the programme may be a hindrance to the process

20. Management of the Health data ●central data are necessary ● local intelligence  local data to assess the situation and take decisions at the peripheral level of the health system (e.g. in health centres, field mobile units, mobile clinics).  Be creative in the collection and use of data,  Use your good judgment, intuition, experience, understanding of the local conditions and needs.  good observers and know what they are looking for and how to evaluate the information

21. The planning structure Planning levels: ●centrally to set national strategies and guidelines ●peripherally to implement the national programme Pyramid ●National health and development policy ●Elimination plan ●Implementation plan ●M& E plan

22. National Development ●Malaria elimination is an integral part of any national development plan ●Poverty reduction strategy ●Place of malaria in national health plan ●Elimination benefits poor, marginalized groups, promoting equity ●Strengthening the malaria programme with a view to elimination will ensure increasing coverage with laboratories and treatment facilities, and strengthening surveillance, and will benefit programmes of other VBDs

23. Elimination M&E framework ●Control programmes, surveillance focus on illness and mortality reduction. ●In elimination program surveillance methods focus also on detecting infections (with or without symptoms) and on transmission dynamics

24. P.f. prevalence (2015) Current estimated P.f. prevalence (2007) Source: NSP Somalia 2010

25. Mewlana Jalaluddin Balkhi Rumi 1207- 1273:Discourses of Rumi (44)).

26. Learning Exercise ●writing a plan for malaria elimination. ●A proposed outline for such a plan is shown in Annex 23  Where possible, information should be provided in charts, tables, maps and graphs. These can be in the text or included in annexes.  one-page summary will be essential for the ministerial levels.  By putting most of the data and detailed information into annexes, the body of the plan can be kept to a minimum.  The text should be clear and concise, stating the effective period of the plan, (allowing at least one year for it to be approved) and the date the plan was formulated, the names and designation of the planning team members.