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The process of changing national malaria treatment policy: lessons from country-level studies.

机译：改变国家疟疾治疗政策的过程：国家一级研究的教训。

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摘要

Widespread resistance of Plasmodium falciparum parasites to commonly used antimalarials, such as chloroquine, has resulted in many endemic countries considering changing their malaria treatment policy. Identifying and understanding the key influences that affect decision-making, and factors that facilitate or undermine policy implementation, is critical for improving the policy process and guiding resource allocation during this process. A historical review of archival documents from Malawi and data obtained from in-depth policy studies in four countries (Tanzania, South Africa, Kenya and Peru) that have changed malaria treatment policy provides important lessons about decision-making, the policy cycle and complex policy environment, while specifically identifying strategies successfully employed to facilitate policy-making and implementation. Findings from these country-level studies indicate that the process of malaria drug policy review should be institutionalized in endemic countries and based on systematically collected data. Key stakeholders need to be identified early and engaged in the process, while improved communication is needed on all levels. Although malaria drug policy change is often perceived to be a daunting task, using these and other proven strategies should assist endemic countries to tackle this challenge in a systematic fashion that ensures the development and implementation of the rational malaria drug policy.
机译：恶性疟原虫寄生虫对常用抗疟药（例如氯喹）的广泛耐药性导致许多流行国家考虑改变其疟疾治疗政策。识别和理解影响决策的关键影响以及促进或破坏政策实施的因素，对于改进政策流程和指导流程中的资源分配至关重要。对马拉维档案文件的历史回顾以及在四个国家（坦桑尼亚，南非，肯尼亚和秘鲁）改变了疟疾治疗政策的深入政策研究中获得的数据，为决策，政策周期和复杂政策提供了重要的教训环境，同时具体确定成功采用的策略以促进政策制定和实施。这些国家级研究的结果表明，疟疾药物政策审查过程应在流行国家中制度化，并应系统地收集数据。需要尽早确定关键的利益相关者并参与其中，同时还需要在各个层面上加强沟通。尽管人们通常认为改变疟疾药物政策是一项艰巨的任务，但使用这些和其他行之有效的策略应有助于流行国家以系统的方式应对这一挑战，以确保制定和实施合理的疟疾药物政策。

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