Strengthening Management, Community Engagement, and Sustainability of the Subnational Response to Accelerate Malaria Elimination in Namibia

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  • 1 Institute for Global Health Sciences, University of California–San Francisco, California;
  • | 2 Ministry of Health and Social Services, Namibia;
  • | 3 Independent Consultant, Windhoek, Namibia;
  • | 4 Bristol Business School, University of West of England, United Kingdom;
  • | 5 College of Business, Law & Governance, James Cook University, Australia;
  • | 6 Business School, University of Exeter, United Kingdom;
  • | 7 Department of Disease Control, London School of Hygiene and Tropical Medicine, United Kingdom

Leadership and management skills are critical for health programs to deliver high-quality interventions in complex systems. In malaria-eliminating countries, national and subnational health teams are reorienting strategies to address focal transmission while preventing new cases and adapting to decentralization and declines in external financing. A capacity-strengthening program in two regions in Namibia helped malaria program implementers identify and address key operational, political, and financial challenges. The program focused on developing skills and techniques in problem-solving and teamwork, engaging decision-makers, and using financial evidence to prioritize domestic resources for malaria through participatory approaches. Results of the program included an observed 40% increase in malaria case reporting, 32% increase in reporting and tracing of imported malaria cases, 10% increase in malaria case management, integration of malaria activities into local operational plans, and an increase in subnational resources for malaria teams. To promote program sustainability beyond the implementation period, key program aspects were institutionalized into existing health system structures, program staff were trained in change leadership, and participants integrated the skills and approaches into their professional roles. A capacity -strengthening program with joint focus on leadership, management, and advocacy has potential for application to other health issues and geographies.

Author Notes

Address correspondence to Amanda Marr Chung, Institute for Global Health Sciences, University of California–San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 95158. E-mail:

Financial support: Funding for this paper and the program of work implemented in Namibia was from the Bill & Melinda Gates Foundation, grant number OPP1160129.

Authors’ addresses: Amanda Marr Chung, Eliza Love, Sara Rossi, Erika Larson, Bruce Agins, and Roland Gosling, University of California–San Francisco, San Francisco, CA, E-mails:,,,,, and Julie Neidel and Idah Mendai, University of California Global Programs, Windhoek, Namibia, E-mails: and Sackeus Nairenge and Jerobeam Hamunyela, Ministry of Health and Social Services, Namibia Windhoek, Namibia, E-mails: and Lesley-Anne Van Wyk, Independent Consultant, Windhoek, Namibia, E-mail: Peter Case, University of the West of England, Bristol, United Kingdom, E-mail: Jonathan Gosling, University of Exeter, Business School, Exeter, United Kingdom, E-mail: Greyling Viljoen, Independent Consultant, Johannesburg, South Africa, E-mail: Macdonald Hove, Independent Consultant, Harare, Zimbabwe, E-mail: