Implementing effective community engagement for malaria control and elimination

Malaria elimination presents numerous operational challenges, including how best to target and tailor malaria strategies to ensure effective coverage of quality malaria services among populations at risk. Targeting and tailoring requires not only good data, but adaptive management, local flexibility, and renewed commitments to community engagement. Community engagement can support the tailoring of malaria strategies across different geographic and social contexts. When implemented as a participatory process that directly involves communities in decision-making, managing activities, and measuring results, community engagement has the potential to (1) improve program design and implementation; (2) align the needs and priorities of national programs and the populations they serve; and (3) ensure programs are relevant and responsive to the local context.

However, community engagement is not consistently defined, operationalized, or evaluated. To address these gaps, this report outlines the key principles of effective community engagement and identifies opportunities to operationalize these principles by optimizing existing health structures and processes. This background paper was informed by a review of published and grey literature as well as a series of case studies that consisted of key informant interviews, focus group discussions, and site visits.

Results from the case studies and literature indicate that community engagement should be coordinated from administrative units closer to the community level and that health services should be responsive to the local context. CHWs, health committees, and other community platforms can be better integrated into the health system and encouraged to facilitate community engagement through improved program management practices. SBCC and participatory methods can be leveraged to support and reinforce this process. Community engagement takes time and is a complex process that is influenced by an array of different contextual factors. As a result, it is often considered difficult to measure and is under-resourced, especially when the program relies on short grant funding cycles. The application of minimum quality standards and more novel approaches to measuring community engagement outcomes and processes are necessary.

In order to make progress, the report identifies three key actions that must take place. First, a common definition for community engagement should be agreed upon and endorsed by malaria funders and global stakeholders. Second, funding agencies should request that proposals include work plans that fully expand current efforts to truly engage affected communities in the planning and execution of malaria programming. Third, malaria programs must link existing community structures to the health system by building systematic community consultation into their district and provincial planning processes and ensure that listening is bi-directional. The report delves deeper to outline specific recommendations for national malaria programs, funders, and implementing partners to drive effective community engagement. It also illustrates an operational model for community engagement that reimagines the roles, responsibilities, and relationships between national malaria programs, district-level health units, and community platforms.

Full report: Implementing effective community engagement for malaria control and elimination: Opportunities and challenges
Two-page brief: Implementing effective community engagement for malaria control and elimination: Opportunities and challenges
Publication: What is community engagement and how can it drive malaria elimination? Case studies and stakeholder interviews