Table 3 Action items for border malaria

Early planning and management

To ensure comparable progress towards the sustainable development goals in border areas,

• Direct additional resources to border areas to improve the infrastructures, the access to health services and the strength of health system

• Establish and implement policies that provide inclusive malaria services for all populations, including non-citizens, undocumented migrants, and refugees

• Develop high-level political strategies, engage stakeholders and take prompt actions to return peace, justice, and access to healthcare in border areas with conflicts and political instability

• Address major social determinants of health such as education, wealth, employment, and social protection

Define the malaria problem in border area

Perform a situation analysis to define and characterize the malaria problems in border areas which could include

• Delineate the geographical boundaries of malaria transmission through the review of available data and field visits; identify the source of malaria importation and their destination; and differentiate border malaria from malaria importation

• Review information on determinants and contextual factors for malaria transmission at borders including malaria ecology, geography, environmental features, demographic characteristics of interested populations, cross border movements and political context

• Assess the availabilities and access to health care, the coverage and quality of surveillance, the implementation of malaria interventions and their impact

• Assess whether a shared transmission focus was formed across borders

• Determine the reasons underpinning the inadequate access to health care, inadequate surveillance and suboptimal implementation of malaria intervention wherever relevant, determine whether the cross border collaboration is appropriate, and develop strategies and interventions

Cross-sector and cross-border collaboration

• Cross-sector collaboration

– Establish mechanisms for intra- and intersectoral information-sharing

– Coordinate and synergize the efforts for malaria control, elimination and prevention [40]

• Cross-border collaboration

– Jointly conduct a situation analysis with neighbours to identify areas of interest for cross-border collaboration. This can help better define the geographical boundaries of malaria transmission and determine the source and destination of importation where relevant

– Engage key stakeholders, including a neutral third party, to establish the information-sharing mechanism and to identify joint activities (e.g. synchronize vector control) to maximize the impact of interventions and achieve the malaria goals

– Reach a consensus on cross-border collaboration

– Mobilize resources for implementation. Jointly monitoring and evaluation to assess impact