Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

Malaria Journal

Case Study

Ann H Kelly¹  Deo Mtasiwa²  Khadija Kannady²  Prosper P Chaki³  Gerry F Killeen⁴  Hassan Mshinda⁵  Marcel Tanner⁶ 

[1] Anthropologies of African Biosciences, London School of Hygiene and Tropical Medicine, Room 201, 15–17 Tavistock Place, WC1H 9SH, London, UK;Department of Sociology, Philosophy and Anthropology, University of Exeter, EX4 4PJ, Exeter, UK;Dar es Salaam City Council, Ministry of Regional Administration and Local Government, Dar es Salaam, United Republic of Tanzania;Ifakara Health Institute, Environmental Health and Ecological Sciences Thematic Group, PO Box 78373, Kiko Avenue, Mikocheni, Dar es Salaam, United Republic of Tanzania;Ifakara Health Institute, Environmental Health and Ecological Sciences Thematic Group, PO Box 78373, Kiko Avenue, Mikocheni, Dar es Salaam, United Republic of Tanzania;Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK;Ministry of Science and Technology, Commission of Science and Technology (COSTECH), Dar es Salaam, United Republic of Tanzania;Swiss Tropical and Public Health Institute, Basel, Switzerland;

关键词: Larval source management;    Governance;    Implementation;    Mosquito;    Malaria;    Anopheles;    Plasmodium;    Community-based;   

DOI  :  10.1186/1475-2875-13-245

 received in 2014-03-26, accepted in 2014-06-01,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundCommunity-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular.Case descriptionThe institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales.Discussion and evaluationThe clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme.ConclusionsThe UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes.

【 授权许可】

CC BY   
© Chaki et al.; licensee BioMed Central Ltd. 2014