Table 2.

Technical, operational, and resource allocation challenges of key malaria interventions elicited from key informant interviews

Issues discussed	Operational	Technical	Resource allocation
Indoor residual spraying	● Access and weather difficulties	● Does not cover mobile population	● Insufficient spray men
	● Homeowner/community refusals		● Delayed insecticide procurement in 2008
	● Late staff payments	● Not as effective against outdoor biting/resting vectors
	● Turnover/retraining		● Irregular trainings
	● No documented strategy on targeting populations		● Lack of some IRS equipment
Long-lasting insecticide-treated nets	● Unclear/outdated targeting	● Does not cover mobile population	● Insufficient supplies of LLINs and resource mechanism for distribution
	● High turnover of community volunteers	● Not as effective against outdoor biting/resting vectors
	● LLINs misused by recipients		● Insufficient IEC for proper use of LLINs
Diagnosis & treatment	● No official change in policy (until 2012)		● Trainings not organized or timed to coincide with new commodity rollout
	● No concentrated strategy across regions
			● Insufficient IEC for dispelling myths and emphasizing need for prompt diagnosis and treatment
	● Some malaria patients reluctant to provide accurate contact or place of origin information.
	● Some health workers perceive RDTs to be too time-consuming
Surveillance/Reporting	● No analysis/feedback	● Reporting systems not linked across health system levels or regions	● Lack of personnel
	● Private sector not included