Abstract for: Exploring Conceptual Simulation Modeling to Develop a Strategic Perspective on Health System Malaria Response
The Regional Malaria Elimination Initiative (RMEI) is an initiative to support seven Central American countries and the Dominican Republic in taking the final steps necessary to eliminate malaria in their territories. The RMEI pairs results based financing with technical assistance to support locally tailored investments in health systems strengthening. Baseline data from RMEI revealed a challenging picture of malaria elimination activities in the region. This practitioner application presentation describes an exploratory effort to: develop a conceptual simulation model to support strategic thinking around potential impact and tradeoffs of interventions; communicate the logic of this novel systemic intervention; and to investigate implementation and management dynamics in dialogue with country partners. A rapidly developed, roughly parameterized model was built with the RMEI evaluation team to describe dynamics case identification and treatment delays. This modeling effort supported the development of insights into the competition between reinforcing loop of infection and balancing loops of diagnosis and treatment; importance of managing drop-off along treatment pathways when understanding transmission risk, and the interconnectedness of surveillance based strategies with identification, treatment, and response infrastructure. The presentation closes with a discussion of opportunities for integrating system dynamics modeling with complementary analytic and other modeling approaches.