title: National malaria vector control policy: an analysis of the decision to scale-up larviciding in Nigeria.
abstract: BACKGROUND
  New vector control tools are needed to combat insecticide resistance and reduce malaria transmission. The World Health Organization (WHO) endorses larviciding as a supplementary vector control intervention using larvicides recommended by the WHO Pesticides Evaluation Scheme (WHOPES). The decision to scale-up larviciding in Nigeria provided an opportunity to investigate the factors influencing policy adoption and assess the role that actors and evidence play in the policymaking process, in order to draw lessons that help accelerate the uptake of new methods for vector control.
  
  
  METHODS
  A retrospective policy analysis was carried out using in-depth interviews with national level policy stakeholders to establish normative national vector control policy or strategy decision-making processes and compare these with the process that led to the decision to scale-up larviciding. The interviews were transcribed, then coded and analyzed using NVivo10. Data were coded according to pre-defined themes from an analytical policy framework developed a priori.
  
  
  RESULTS
  Stakeholders reported that the larviciding decision-making process deviated from the normative vector control decision-making process. National malaria policy is normally strongly influenced by WHO recommendations, but the potential of larviciding to contribute to national economic development objectives through larvicide production in Nigeria was cited as a key factor shaping the decision. The larviciding decision involved a restricted range of policy actors, and notably excluded actors that usually play advisory, consultative and evidence generation roles. Powerful actors limited the access of some actors to the policy processes and content. This may have limited the influence of scientific evidence in this policy decision.
  
  
  CONCLUSIONS
  This study demonstrates that national vector control policy change can be facilitated by linking malaria control objectives to wider socioeconomic considerations and through engaging powerful policy champions to drive policy change and thereby accelerate access to new vector control tools.
authors.affiliation: Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, UK.
authors.forename: Kemi
authors.initials: K
authors.lastname: Tesfazghi
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine Pembroke Place, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Hill
authors.affiliation: Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, UK and Department of Public Health Research, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
authors.forename: Caroline
authors.initials: C
authors.lastname: Jones
authors.affiliation: Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, UK.
authors.forename: Hilary
authors.initials: H
authors.lastname: Ranson
authors.affiliation: Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, UK, Eve.Worrall@lstmed.ac.uk.
authors.forename: Eve
authors.initials: E
authors.lastname: Worrall
mesh_terms: D000288:Administrative Personnel / Q000523:psychology; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008288:Malaria / Q000517:prevention & control*; D009032:Mosquito Control / Q000331:legislation & jurisprudence* / Q000379:methods; D009549:Nigeria; D010575:Pesticides; D011050:Policy Making; D036301:Qualitative Research; D012189:Retrospective Studies
chemical_list: D010575:Pesticides
keywords: Larviciding; larval source management; malaria; policy analysis; vector control