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Malaria is seen as a community priority
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Role of CCGs and scope of services offered unclear across community and health facility levels
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Communities have a good understanding of the signs and symptoms of malaria, ways of preventing malaria, and the biological groups most at risk
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A range in skills and experience in the management of malaria among CCGs
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Wide support for a community level distribution of drugs
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Health facility staff perceive CCGs to provide low quality of care
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Community level support for and trust in CCGs
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Weak referral linkage between community and health facility levels
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Close proximity of CCGs to beneficiaries which could enable high intervention coverage and facilitate effective follow-up and monitoring of adverse events
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Community referral action potentially hindered by perception of inadequate skills among health facility staff, inconsistent ACT supply and potential cost of transport and malaria treatment
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High levels of community acceptability of ACT
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Differing opinions on the most effective distribution approach—fixed-point or household-to-household
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Supportive supervision system between health facility and CCGs established (though weak in some areas)
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A lack of consensus over the suggested management of the intervention and potential roles of the health facility and community leadership
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High levels of trust in community traditional and religious leadership, and general consensus that they should play a pivotal role in mobilization for the programme
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Low storage capacity at the community level
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Community leadership frequently involved in disseminating health information to their communities and so have basic health knowledge and local information dissemination systems are established
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Potential security issues relating to the distribution of drugs at the community level
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Simple, visual communication materials written in local languages could be well accepted
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Varying levels of capacity for effective reporting among CCGs
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Low levels of community literacy (particularly among women) which may inhibit understanding of any written guidance or communication materials as well as record keeping capacity
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Potential suspicions of ‘outside’ interventions, exacerbated by negative associations with the polio campaign
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