Table 1 Malaria epidemiology, decision making structures and policies for control

Epidemiology

 Overview

High variability in malaria parasite prevalence across the country, with endemic counties around Lake Victoria and on the coast, epidemic-prone counties in the highland areas, seasonal counties and low risk counties around Nairobi [51,52,53]

Relatively homogeneous prevalence of malaria with higher burden along Lake Malawi in the Central and Southern regions [54]

Homogeneous hyperendemic to holoendemic malaria transmission across the country, with the exception of the mountainous area in the eastern provinces (0.2% of the population), and in the capital city Kinshasa [55, 56]

 Number of estimated cases in 2018 (GMR2019)

3.6 M

3.8 M

26.8 M

 Number of estimated deaths in 2018 (GMR2019)

12,416

6678

44,615

 Main vectors

Predominance of An. arabiensis and An. gambiae s.s

Predominance of An. gambiae, and minority of An. arabiensis and An. funestus

Predominance of An. gambiae and An. funestus. In addition presence of An. moucheti, An. nili

Decision-making for malaria control

 Administrative levels of decision-making

Since 2010 Kenya has a decentralized system of 47 counties. The counties are assigned the service delivery functions while the national government provides national referral, policy guidelines, capacity building and technical assistance

Malawi is divided into three regions and 28 districts (local government units), which are further divided into Traditional Authorities ruled by a chief

Policies are defined at national level; districts have technical support and monitoring functions

The country reorganised the province level in late 2015 increasing the number of provinces from 11 to 26

Policies are determined at national level. Health directorates, present in the 26 provinces, perform functions of technical support and monitoring. Under the health directorates there are 65 health districts and 515 Health zones. The Health Zone is the operational unit for planning and implementation of the national health policy

 Dates when NMCPs was established

2000

1984

1998

 National Malaria Strategic Plans (post-RBM)

2001–2010

2009–2018

2019–2023

1990–1994

2001–2005

2005–2010

2011–2016

2017–2022

2002–2006

2007–2011

Replaced by 2009–2013 NMSP (in line with RBM targets)

Replaced by 2011–2015 NMSP aligned with the broader health sector strategic plan

2016–2020

 GF and PMI support start dates

GF: 2002

PMI: 2008

GF: 2003

PMI: 2007

GF: 2003

PMI: 2011

Policies

 LLINs policies

LLINs are delivered through mass and routine distribution, including at ANC and Child Welfare Clinics, in the 23 endemic and epidemic-prone and the 13 malaria-prone counties

LLINs are delivered through mass and routine distribution at ANC and implemented universally

LLINs are delivered through mass and routine distribution at ANC and implemented universally

 IPTp policies

IPTp 3 plus is delivered at routine ANC visits and implemented in the 14 lake and coastal endemic counties

IPTp 3 plus is delivered at routine ANC visits and implemented universally

IPTp 3 plus is delivered at routine ANC visits and implemented universally

 IRS policies

The NMCP targets spraying in the lake-endemic counties of western Kenya (7 counties)

The NMCP targets spraying according to level of risk and budget availability (along Lake Malawi and in the southern districts)

The NMCP targets spraying according to level of risk and budget availability