Strengthening Public Sector Capacity through Malaria Core Team Strategy: An Implementation Science and Management Study from Ogun State, Nigeria
Abstract:
Limited government ownership, weak coordination mechanisms, and dependence on implementing partners continue to threaten the sustainability of donor-funded health programs in Nigeria. Strengthening sub-national program management capacity is therefore essential to institutionalizing implementation gains within the public sector. The Malaria Core Team (MCT) strategy was introduced in Ogun State, Nigeria (2021–2023) as an embedded implementation approach aimed at strengthening government-led supportive supervision, mentorship, and program management within the State Malaria Elimination Program (SMEP). A descriptive implementation science case study design was used to evaluate the MCT strategy within the Global Fund malaria grant implemented by Management Sciences for Health (MSH). The intervention paired SMEP personnel with MSH staff to conduct joint supportive supervision visit and on-the-job mentoring and coaching at health facility level. A retrospective review of routine program monitoring data, supervision reports, training records, and qualitative feedback from program managers was conducted. Quantitative outputs were analyzed descriptively, while qualitative data were analyzed using directed content analysis to assess implementation outcomes including adoption, fidelity, leadership transition, and sustainability. The MCT conducted joint supportive supervision visits to 180 health facilities and trained 450 health workers on malaria case management, commodity accountability, and service reporting. Progressive adoption of the strategy by SMEP personnel demonstrated improved implementation fidelity and institutional ownership. Programmatic outcomes included improved adherence to national malaria treatment guidelines, increased completeness and timeliness of reporting, enhanced routine data quality, and improved reconciliation of logistics management information system data, contributing to better on-shelf availability of antimalarial commodities. The MCT strategy demonstrates how embedded mentorship and collaborative implementation approaches can strengthen sub-national program management capacity and promote sustainability of donor-funded malaria interventions.References:
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