Financing and delivery mechanisms for mosquito control tools in Sudan: A Strengths Weaknesses Opportunities and Threats (SWOT) analysis.

Abstract

Background: Malaria is a major public health problem in Sudan and causes an enormous burden of morbidity in the country. Malaria is generally controlled in Sudan using five main approaches, which are environmental management, space spraying (SS), insecticide-treated nets (ITNs), larviciding with abate (LWA) and indoor residual house spraying (IRHS). However, it is not clear which options or mix of options present the most economically viable means in terms of financing and delivery, for malaria control.                                                                                                    Methods: The study used an interviewer-administered questionnaire administered to malaria control managers at national and sub-national levels, as well as the review of documents to collect information at three levels of service delivery: National, State and Local. Three localities were selected from each state to represent an urban, peri-urban and rural area. Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis is undertaken on the financing and delivery schemes. The respondents assigned scores based on several SWOT indicators, which were: dependability, sustainability, timeliness, equity, sufficiency, and affordability. The scores for the different SWOT indicators were added-up for each vector control mechanism.                                                         Findings: The funding for the four strategies was dependable but only the funding for ITNs was rated highest on the sustainability criterion and financing of IRHS and SS were deemed not to be sustainable. Overall, financing of LWA followed by ITNs had the highest SWOT analysis scores on the financing criterion. The delivery strategies of three out of four vector control activities were rated poorly efficient, integrated, and timely. Only the delivery of ITNs and LWA were rated by the control managers as optimally sustainable. Overall, the delivery of LWA, followed by ITNs, was rated highest on the delivery criterion.
Conclusion: SWOT analysis revealed critical issues with financing and delivery of the different malaria vector control interventions. These issues need to be resolved for optimal malaria control activities in Sudan.

Keywords: Financing and delivery mechanisms; mosquito control tools; SWOT analysis; Sudan.