Infectious disease control guidelines in developing countries: A case study of malaria control policy in Uganda

Background: Programs to control of infectious diseases are most often carried out according to guidelines formulated by the international health community based on tested best practices. Despite the malaria control policy adhering to international recommendations, malaria is still a leading cause of under-five mortality. This study aimed at asking how malaria policy in Uganda is formulated and implemented and if the national control program is effective in reducing the country's malaria burden.

Methods: This study was conducted in two parts, first, through qualitative field research in Kampala, Uganda, employing both formal and informal interviews and participant observation methods. Second, recommendations based on the field research were incorporated into the development of a new intervention program to test the research conclusions.

Results: Field research concluded that the recommended malaria control policy was not being implemented and evidence-based interventions were not experiencing uptake on the ground. Involvement in formulation of policy was limited and the top-down program approach was failing to combat malaria effectively. Consequently, an alternate approach to delivering malaria interventions in Uganda is necessary.

Conclusions: New intervention approaches based on field study recommendations should be carried out in a pilot program in one district and outcomes compared to the results of the current control program. Unless this occurs there is a risk of the development of drug-resistance and high malaria mortality.