Strengthening Capacity in High-Burden Malaria-Endemic Countries: A Strategic Analysis of Training Gaps and Blended Learning Solutions in National Malaria Control Programs

Background Malaria remains a significant public health challenge worldwide, with approximately 70% of the disease burden concentrated in 11 High-Burden to High-Impact (HBHI) countries, as identified by the World Health Organization (WHO). Notwithstanding considerable investments and advancements in malaria interventions, such as Insecticide-Treated Nets (ITNs), rapid diagnostic tests (RDTs) and Artemisinin-based Combination Therapy (ACT), Indoor Residual Spraying (IRS), Seasonal Malaria Chemoprevention (SMC), and the recent introduction of vaccines, persistent Human Resource (HR) capacity deficiencies considerably undermine the effectiveness and sustainability of malaria control initiatives. Pre-service training and continuing education are often sub-optimal for Community Health Workers (CHWs), district health officials, and national program managers with respect to diagnostic procedures, case management, prevention, community engagement, data analytics, and program implementation, particularly in remote and high-transmission environments. Methods This analysis employed a mixed-methods approach that integrated a review of peer-reviewed literature, reports from the WHO and donor agencies, and case studies from HBHI countries. Data from national health information systems, such as District Health Information System 2 (DHIS2), and malaria program reports were compiled and evaluated using an Impact-Feasibility Matrix. Systemic relationships were mapped across the community, district, and national levels. At the same time, recommendations were substantiated through consultations with technical experts, Malaria Policy Advisory Group (MPAG) members, managers of National Malaria Control Programs (NMCP), and partner organizations. Results Significant training and workforce shortages were identified at all tiers of the health system. At the community level, deficiencies in CHW training and supervision were correlated with instances of misdiagnosis, treatment delays, and low levels of community engagement. District-level challenges included suboptimal supply chain management, insufficient surveillance mechanisms, and limited managerial capabilities. At the national level, constraints involved inadequate expertise in research, surveillance, data analysis for policy adaptation and prioritization for subnational tailoring, and leadership. To mitigate these issues, a blended learning strategy that encompasses self-paced digital modules, virtual mentoring, and Outreach Training and Supportive Supervision (OTSS) is recommended. An application of Kirkpatrick’s four-level evaluation framework of outcomes was also recommended to assess the impacts of the proposed training strategies that would enhance learner satisfaction, knowledge acquisition, practical application, and the overall health outcomes. The Training Resource Hub, created by Malaria Eradication Scientific Alliance (MESA), has been strengthened by the inclusion of data from this study to provide an inventory of blended malaria-related training opportunities to malaria program leaders worldwide. Conclusions Enhancing the workforce capacity for malaria control through blended learning methodologies can effectively bridge critical HR gaps in HBHI countries. By incorporating context-specific training, digital resources, and sustainable mentorship frameworks, malaria programs can significantly improve operational efficiency, service delivery, and strategic planning. Many of these strategies have already demonstrated benefits at the local or regional level, and the wider application of lessons learned is essential if malaria elimination targets in resilient health systems are to be achieved. With the threat of an imminent decrease in donor funding, it is more important than ever that local capacity is strengthened for implementation of best practice at all levels of the health care system.