Table 2 Main implications for considerations of malaria prophylaxis as a strategy

Prophylaxis as a part of malaria intervention

1. Target forest goers who are most at-risk from their activities with a clear period of exposure as well as those who work in forest farms during the night

2. Forest goers prefer minimal numbers of tablets for a short period (only during forest visits); potential side effects are the main concern among locals

3. The intervention is less prioritized in areas with good access to care. However, some forest goers in these areas may choose not to visit (or delay visiting) a public health facility for various reasons.

Choice of regimen

4. Choice of anti-malarial regimen is a key determinant of feasibility (including its cost, efficacy, length and complexity, number of tablets, potential side effects, its safety and long-term impact on users)

5. Avoid administering anti-malarials that are currently used as first-line treatment for the target population

6. Adherence to prophylactic therapy remained a key concern in the context of multi-drug resistance

Delivery of prophylaxis and provider

7. VMW and/or sub-district hospital could be an appropriate provider to deliver prophylaxis along with diagnosis and treatment; they can also monitor and follow-up to ensure uptake of, and adherence to the prophylaxis regimen

8. Training is needed for VMWs to equip them with knowledge and supply as a reliable provider as perceived by community members

Messages about prophylaxis

9. Emphasize the importance of adhering to the prophylactic medicine

10. Encourage continuing use of other protection measures from mosquito bites and visiting public health facilities for clinical treatment when they have malaria symptoms