Challenges and opportunities for greater public-private partnership for the implementation of the WHO operational framework for building climate resilient health systems to improve malaria control and elimination in Sub-Saharan Africa: a rapid review.

Abstract

The relationship between climate change and malaria is complex, with both predictable and unpredictable aspects. The impacts of climate change may promote mosquito breeding, increase parasite development rates and extend the geographical range of malaria vectors through increased temperature and rainfall. In addition, climate change influences the transmission of malaria indirectly through social and economic pathways. The gains made in malaria control are evidently under threat. Partnerships to build climate resilient health systems for malaria control in Sub-Saharan Africa (SSA) should be harnessed to implement the WHO Operational Framework in SSA. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Centre for Reviews and Dissemination (CRD) guidelines. A search strategy was formulated based on the PECOS framework using BOOLEAN operators "AND" and "OR" for all possible combinations of the following search teams: public-private sector partnerships, public health, and Sub-Saharan Africa. We identified 173 research papers from our database searches, and this systematic review includes 11 articles focusing on the objective of this study. The included studies identified challenges such as ineffective legal and policy frameworks, bureaucracy, limited buy-in and adherence to guidelines by private partners and a lack of systemic integration of climate risk assessments in health planning among others. On the other hand, opportunities lie within the health workforce, essential medicines and technologies, and emergency preparedness and management. These include health workforce education and training through massive open online courses, proper response targeting in partnership with the private sector, and co-production mechanisms for climate change and malaria research. PPPs remain a viable alternative in the adaptation of the WHO Operational Framework despite the challenges they face. This is particularly the case when the technical and financial capacities of the countries in the SSA region are considered. There are lessons to be derived and best practices to be instituted from case studies of previous partnerships, especially in malaria control.