title: Policy analysis for deciding on a malaria vaccine RTS,S in Tanzania.
abstract: BACKGROUND
  Traditionally, it has taken decades to introduce new interventions in low-income countries. Several factors account for these delays, one of which is the absence of a framework to facilitate comprehensive understanding of policy process to inform policy makers and stimulate the decision-making process. In the case of the proposed introduction of malaria vaccines in Tanzania, a specific framework for decision-making will speed up the administrative process and shorten the time until the vaccine is made available to the target population.
  
  
  METHODS
  Qualitative research was used as a basis for developing the Policy Framework. Interviews were conducted with government officials, bilateral and multilateral partners and other stakeholders in Tanzania to assess malaria treatment policy changes and to draw lessons for malaria vaccine adoption.
  
  
  RESULTS
  The decision-making process for adopting malaria interventions and new vaccines in general takes years, involving several processes: meetings and presentations of scientific data from different studies with consistent results, packaging and disseminating evidence and getting approval for use by the Ministry of Health and Social Welfare (MOHSW). It is influenced by contextual factors; Promoting factors include; epidemiological and intervention characteristics, country experiences of malaria treatment policy change, presentation and dissemination of evidence, coordination and harmonization of the process, use of international scientific evidence. Barriers factors includes; financial sustainability, competing health and other priorities, political will and bureaucratic procedures, costs related to the adoption and implementations of interventions, supply and distribution and professional compliance with anti-malarial drugs.
  
  
  CONCLUSIONS
  The framework facilitates the synthesis of information in a coherent way, enabling a clearer understanding of the policy process, thereby speeding up the policy decision-making process and shortening the time for a malaria vaccine to become available.
authors.affiliation: Swiss Tropical and Public Health Institute, Socinstrasse 57, Postfach, 4002, Basel, Switzerland. iromore@ihi.or.tz.|University of Basel, Basel, Switzerland. iromore@ihi.or.tz.|Ifakara Health Institute (IHI), P.O. Box 78373, Dar Es Salaam, Tanzania. iromore@ihi.or.tz.
authors.forename: Idda
authors.initials: I
authors.lastname: Romore
authors.affiliation: World Health Organization Country Office, P.O Box 9292, Dar Es Salaam, Tanzania. Njau-njaur@who.int.
authors.forename: Ritha J A
authors.initials: RJ
authors.lastname: Njau
authors.affiliation: Muhimbili University of Health and Allied Science (MUHAS), P.O. Box 65015, Dar Es Salaam, Tanzania. innosemali@yahoo.com.
authors.forename: Innocent
authors.initials: I
authors.lastname: Semali
authors.affiliation: Centres for Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Mwisongo2@wits.ac.tz.
authors.forename: Aziza
authors.initials: A
authors.lastname: Mwisongo
authors.affiliation: Agence de Médecine Préventive, 08BP 660, Abidjan, Côte d'Ivoire. aba-nguz@aamp.org.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Ba Nguz
authors.affiliation: Commission for Science and Technology (COSTECH), P.O. Box 4302, Dar Es Salaam, Tanzania. hmshinda@costec.or.tz.
authors.forename: Hassan
authors.initials: H
authors.lastname: Mshinda
authors.affiliation: Swiss Tropical and Public Health Institute, Socinstrasse 57, Postfach, 4002, Basel, Switzerland. marcel.tanner@unibas.ch.|University of Basel, Basel, Switzerland. marcel.tanner@unibas.ch.
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.affiliation: Ifakara Health Institute (IHI), P.O. Box 78373, Dar Es Salaam, Tanzania. sabdulla@ihi.or.tz.
authors.forename: Salim
authors.initials: S
authors.lastname: Abdulla
mesh_terms: D003661:Decision Support Techniques; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D008288:Malaria / Q000517:prevention & control; D017780:Malaria Vaccines; D036301:Qualitative Research; D013636:Tanzania
chemical_list: D017780:Malaria Vaccines