The District-level Readiness for Elimination of Malaria Tool (DREAM-IT)

What is readiness for malaria elimination?

Malaria elimination readiness refers to a state of being fully prepared to achieve malaria elimination. Readiness for malaria elimination is determined by a variety of health system structures and effectiveness and adaptability of these structures. The success of elimination efforts depends upon the epidemiological and entomological surveillance systems. As part of the transition from malaria control to malaria elimination, malaria programs in low-transmission settings must strengthen their readiness for elimination by examining and addressing financial, technical, operational, and programmatic needs and gaps.

What is the DREAM-IT and why is it useful?

DREAM-IT aims to inform program planning for malaria elimination strategies and activities within subnational districts and provinces by assessing the readiness of community health workers, health facilities, and district-level health systems to implement and sustain elimination activities. Specifically, the District-level Readiness for Elimination of Malaria Tool (DREAM-IT) facilitates the identification of capacity gaps and operational constraints to achieving elimination through analysis of 15 core thematic areas. DREAM-IT is a series of five assessment modules with each module corresponding to one level of the health system: national, provincial, district, health facility, and community health worker (CHW). The district module questionnaire is the core module of the tool. DREAM-IT modules are comprised of up to 15 thematic areas, each containing a series of questions related to that area. Depending on the assessment objectives and available resources, programs can choose which module levels to include in the assessment and tailor the questions according to country context and priorities.

Who should use this tool and how?

DREAM-IT has been developed for use by anyone – national malaria program staff, partner organizations, research institutions, evaluators, donors, or others – to conduct an assessment of a national malaria program to implement malaria elimination strategies and activities. Countries have used DREAM-IT assessment results to identify key operational strengths and gaps, make improvements in operational strategies and plans, update malaria program national strategic plans and advocate for malaria elimination resource mobilization.


The DREAM-IT tool is available in English and French.