Understanding the use of geospatial disease mapping in malaria risk stratification and intervention targeting across sub-Saharan Africa

Malaria risk maps are a critical tool to assist national malaria programmes in the prioritization and targeting of their malaria control activities to maximize efficacy and equity, especially under conditions of resource constraint. The research study sets out to answer a core series of questions pertaining to the use of malaria mapping, the actors involved, the mapped outputs produced, and approaches for their improvement and knowledge translation. The research study conducts a narrative literature review and an audit of over 100 control programme documents from 47 malaria-endemic sub-Saharan African countries to better understand the typologies of malaria risk maps, their development, their applications, and their potential value across different decision-making levels. The research study then conducts a thematic analysis of 17 qualitative, in-depth interviews held with malaria control stakeholders in Madagascar in order to identify current-state use cases, perceived utility, perceived limitations, and future-state use cases of malaria risk mapping in the country. Finally, the study evaluates the results of a modelled map workshop organized by The Demographic and Health Surveys Program and conducted with technical malaria stakeholders in Madagascar to assess methods for capacity-strengthening and knowledge translation in malaria risk mapping. The research study finds that malaria risk maps are increasingly used in national and sub-national fora, and have perceived value across a range of use cases, including surveillance, intervention stratification, logistics, descriptive epidemiological or climatic visualizations, and predictive analyses. Further explorations of stakeholder perceptions can help to better understand the decision points and trade-offs faced by health policymakers in malaria elimination and control when considering the use of malaria risk maps.