National Malaria Strategic Plan (NMSP) of Madagascar: 2023 – 2027

The Stratégie du Plan Stratégique National de lutte contre le paludisme à Madagascar 2023-2027 focuses on five strategic pillars and a cross-cutting section on strengthening the implementation environment. Each of these five main sections is divided into interventions, activities, and sub-activities, culminating in a comprehensive operational implementation plan.

• Pillar 1 focuses on protecting at-risk populations from vectors through mass and continuous distribution of long-lasting insecticidal nets (LLINs), indoor residual spraying, and integrated vector management. During the 2023-2027 period, the potential of new protection tools will be explored as evidence becomes available.
• Pillar 2 focuses on early diagnosis and appropriate treatment, which are essential, especially in this context, to progressively interrupt local transmission at the district level. Strengthening the community system will ensure that even hard-to-reach and mobile populations receive rapid diagnosis and treatment with quality medicines. The country’s primary health centers, hospitals, and reference laboratories will be strengthened to provide comprehensive malaria control services and ensure continuity of care.
• Pillar 3 provides specific protection to all pregnant women living in targeted areas through intermittent preventive treatment during pregnancy.
• Pillar 4 outlines all the increased and innovative efforts that will be deployed to reach key populations at highest risk, including isolated and insecure populations, mobile and migrant populations, and active hotspots that maintain ongoing malaria transmission. This aims to strengthen the impact of the first three pillars on reducing malaria morbidity and mortality in the general population. To raise awareness and secure community engagement, communication for social and behavioral change (SBCC) will be continuously updated and focused on ensuring ownership of interventions by all at-risk populations.
• Pillar 5 encompasses all efforts undertaken for the surveillance, monitoring, and evaluation of all activities in these strategic areas to guarantee an appropriate response to interrupt transmission. The strategies developed for this plan will ensure comprehensive and accurate reporting. In particular, all confirmed cases will be reported, investigated, and categorized by area of ​​lower transmission to improve coordination of responses.

All potential new outbreaks will be investigated within one week, followed by a targeted response to stop transmission. In this way, outbreaks will also be detected and managed within one week. Sufficient and adequately trained staff will be needed at all levels of the response to fulfill all these functions.

Finally, to optimize the effects of all these interventions, strengthening the health system and improving the implementation environment will be crucial for elimination.