Table 3 SWOT analysis of the malaria control programming in South Sudan

• Strong government leadership, political commitment and advocacy for malaria control.

• Minimal government/domestic funding for malaria control and over dependency on donor funding.

• Presence of active multi-sectoral (UN agencies, NGOs/FBOs) national MTWG and thematic groups led by the NMCP.

• Storage of malaria commodities at the central and facility levels are in adequate.

• Availability of policies, guidelines and strategic plans for malaria control and prevention.

• Weak partner linkage and coordination for malaria control at state and county levels.

• A national drug regulatory authority has been inaugurated.

• Inadequate skilled personnel for all aspects of malaria control and frequent staff turnover at all levels.

• Pharmaceutical management TWG to quantify and procurement of WHO prequalified malaria commodities.

• There are no appraisal systems to document non performance and also to motivate those that are performing well.

• Adoption and roll pout of HMM as part of the ICCM.

• Lack of quality assurance and control for malaria commodities and equipment.

• Funding from GFATM and other partners to scale malaria interventions.

• Weak communication system and infrastructure with irregular supervision and feedback mechanisms.

• Availability of capacity to conduct operational research for vector and drug resistance.

• Lack of public health reference laboratory infrastructure and services at central level.

• Good mass media in the country to facilitate health education, promotion and BCC/IEC.

• Limited package and low coverage and utilization of proven malaria vector control tools to attain universal coverage.

• Availability of information sources: HMIS, IDSR, MIS, LQAS and SSHHS.

• Functional sentinel sites for monitoring and surveillance to regularly guide decision making.

• Minimum entomological data to guide evidence-based deployment of tools.

• Adoption of IVM strategy as a platform for vector control in the country.

• Limited technical support, guidance and coordination on health promotion, BCC and IEC.

• Constrained health system that may not cope with added pressures of a national programme expansion.

• Limited definitive diagnosis, frequent stock outs of commodities and unregulated private sector.

Opportunities

Threats

• Availability of high donor funding to support scale-up of interventions.

• Reducing government financial commitment.

• Resistance of malaria parasites and vectors to anti-malarials and insecticides respectively.

• Active RBM partnership and large net work of NGOs and private sector to support malaria programming.

• Sustainability of funding.

• Insecurity and inaccessibility.

• Recently established food and drug authority to regulate and facilitate quality control.

• Increasing populations and availability of displaced populations.

• High technical assistance support.

• Influx of untreated nets and abuse/misuse of nets.

• Great potential for higher-level political support.

• Lack of adherence to national treatment guidelines by the private sector clinics and pharmacies.

• Increasing partner commitment and collaboration to establish an entomological laboratory and operations research.

• Low levels of literacy.

• The IVM strategy allows for deployment of additional tools and integration with other vector-borne diseases.

• Uncoordinated supply of commodities, availability of fake drugs and unregulated donations of drugs.

• Availability of electronic and print media and coverage of mobile phones and community FM radio stations to support BCC/IEC.

• Weak overall health systems.

• Limited research and academic institutions with requisite infrastructure to support malaria research.

• Communities that are willing to be key partners in operations and planning for successful outcomes.