Table 3 Potential contribution to SMC based upon key learnings from China

Incomplete coverage particularly in rural Sahel characterized by poor infrastructure and limited access to essential antimalarial products

Practice 1 Before the start of MDA every year, the provincial, county and township governments holds a mobilization meeting to sign a responsibility letter to agree to the implementation objectives and activities, and determines the number of people who need to take medicine according to the number of cases and targeted population, then provides the necessary drugs to the manufacturer in advance

Practice 2 The county governments holds a multisector meeting, including the county magistrate, health bureau, drug administration bureau, finance bureau, education bureau, radio and television bureau, local CDCs and heads of townships and health centers, to ensure the community’s adoption of medicine, and the whole participation rate should be > 85% as required

Practice 3 The medicine delivery team consisting of 3–5 members at least 1 doctor from the health center, 1 village cadre and 1 village doctor is organized from each natural village to send medicines from door to door

Practice 4 To improve targeted population compliance, the community empowerment campaign is conducted through publicity distributed via TV stations, radio stations, newspapers, etc.; knowledge on malaria control and prevention is posted on the outer walls of the village center and roadside houses in each natural village; a variety of health education products, i.e. aprons for home women, calendar pictures, magnetic soft screen doors, shopping bags, eye charts for students, etc. are distributed for the key stakeholders in the communities

Practice 5 Subsidies and foods (yoghurt, bread, eggs, etc.) are provided to each drug delivery person to ensure the enthusiasm of the grassroots staff

Systems to monitor adverse drug reactions are extremely fragile

Practice 1 Tour supervisory teams at the provincial level and local supervisory teams at the county level are organized to supervise the implementation of MDA in all targeted communities

Practice 2 Trainings are carried out at the provincial, prefectural and county levels before implementation, including identifying potential contraindications to medications and identifying and treating adverse drug reactions

Insufficient funding for SMC scale-up

Practice 1 The national-, provincial- and county-level governments disburse special funding for the purchase of medicines, personnel training and staff subsidies, respectively

Despite SMC, malaria remains a major health issue in rural Sahel

Practice 1 To increase the rounds of MDA and/or targeted prophylaxis in the hotspot areas where the highest transmission continues throughout the year, such as implementing the MDA and/or targeted prophylaxis in the spring (before first peak transmission) and summer (before the second peak transmission) in the high- transmission areas in the 1970s

Practice 2 Based on the local transmission levels to implement the local-tailored interventions, i.e. to carry out piloted interventions in 10 selected counties where the falciparum malaria parasites was still prevalent under routine interventions, and in 8 selected counties where vivax malaria parasites was stubborn

Practice 3 To adjust specific drugs of MDA and/or targeted prophylaxis according to local transmission vectors and parasite, such as adding the primaquine to vivax malaria parasites

Additional interventions beyond LLINs are needed to consolidate SMC efforts

Practice 1 To strengthen the IRS coverage and usage of LLINs, as well as community mobilization and participation in consolidating the MDA and/or targeted prophylaxis efforts