Challenges and opportunities for implementing an intersectoral approach in malaria control in Tanzania

Background: Malaria is a complex health problem related to socio-economic and environmental factors that cut across a number of sectors. Establishing intersectoral linkages is important to facilitate joint efforts to address the problem at all levels. The objectives of this study were to explore key sectoral engagements in malaria control policy formulation and implementation, and to determine decision and policy makers' opinions about different sectoral activities that contribute to malaria transmission and control in Tanzania. Methods: This study included documentary review, self-administered interviews and group discussion. Interviews and group discussions involved key informants at district and national levels. The sectors involved were health, agriculture, environment, livestock, fisheries, education, works, irrigation, water resources, land development, forestry, and community development. Results: Institutions and organizations that were involved in the development of the previous and current National Malaria Strategic Plan (2007-2013 and 2013-2020) were the Ministries of Health and Social Welfare, Prime Minister's Office of Regional Administration and Local Government, Public universities and non-governmental organizations. All the individuals involved in the development of the plans were either medical or health professionals. According to key informants, sectoral activities identified to contribute to malaria transmission included farming systems, deforestation, fishing, nomadic pastoralism, household water storage, water resource development projects, road and house construction and mining. The lack of intersectoral approaches in malaria control programme included the facts that the Health Sector does not involve other sectors during planning and development of policy guidelines, differences in sectoral mandates and management culture, lack of a national coordinating framework and lack of budget for intersectoral activities. Conclusion: The current strategies for malaria control in Tanzania need to address socio-economic and development activities across sectors and emphasise the need for intersectoral collaboration. It is recommended that the future of malaria control strategies should, therefore, be broad based and intersectoral in planning and implementation.