Lessons learned and collaborative models between public health agencies and local administrative organizations at subdistrict level for malaria elimination

Abstract

 Sustainable malaria elimination requires long-term political commitment and financial support. During 2018-2020, the Division of Vector-Borne Diseases under the Department of Disease Control (DDC)
intensely implemented capacity building and mobilized collaboration and support from local administrative organizations (LAOs) at subdistrict level for malaria elimination. The efforts resulted in a significant increase in funding support from 3,714,999 Baht in fiscal year 2017 to 7,530,513 Baht in fiscal year 2020. This qualitative study aimed to identify goals and processes employed by local public health agencies in working collaboratively with LAOs in five high performance provinces and to provide some lessons learned for other areas. Data were collected during January-April 2021 by interviewing 44 key informants, who were administrators and practitioners of public health organizations and LAOs in 11 subdistricts. Analysis was done through thematic analysis and subsequent comparison of commonalities and differences among provinces. The study found three models of engagements: 1) LAO supported budget for malaria related prevention and control activities; 2) Building knowledge and skills of malaria vector control for LAOs in cooperation with public health agencies; and 3) Building local ownership of malaria work through local collaboration with LAOs in subdistrict level, community leaders, village health volunteers, and other stakeholders. Key lessons learned were that setting specific goals for engagement with LAOs by Office of Disease Prevention and
Control and Provincial Health Office was a key factor leading to processes and outcomes. The results showed that building capacity and ownership for LAOs and communities in malaria work can result in sustaining malaria elimination and real public health decentralization.