Assessing scalability factors of a malaria intervention using Malakit and target drug administration among hard-to-reach populations: An original approach focusing on key stakeholders – implementers and decision-makers – in the Guiana shield

Abstract

Introduction

The Guiana Shield faces significant malaria challenges due to a mobile, hard-to-reach population involved in goldmining. Interventions like Malakit (self-testing and self-treatment kits), Targeted Drug Administration against P. vivax, or their combination, aim to combat malaria. These community-based interventions, evaluated in Brazil, French Guiana, and Suriname, show promising results and potential for scale-up. The research aimed to assess the scalability of these interventions by identifying and mapping stakeholders and doing a SWOT analysis for scale-up.

Methods

This pre-planning assessment, conducted from June 2023 to March 2024, involved a collaborative, participatory approach. The process included working sessions with the resource team, semi-structured interviews with stakeholders, and participant observation during formal meetings with stakeholders and the resource team. Field notes have been taken and deductive qualitative analysis has been made using the ExpandNet/WHO Framework. Data was used to design Mendelow's Matrix and SWOT analysis.

Results

Stakeholders were categorized into implementers, decision-makers, beneficiaries, and partners. Mendelow's matrix and SWOT analysis highlighted strengths like Malakit's effectiveness, while weaknesses included data gaps and regulatory challenges. Opportunities for scaling up were linked to malaria elimination initiatives in Brazil, French Guiana, and Suriname, while funding and regulatory issues posed threats.

Discussion and conclusion

Stakeholder analysis is crucial in scaling up public health interventions, identifying key contributors and challenges. Financial and regulatory barriers can hinder scalability, but political and epidemiological factors offer opportunities. Effective collaboration across countries, engaging stakeholders, and advocating for evidence-based decisions are essential for malaria elimination in Brazil, French Guiana, and Suriname.