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Introduction Vietnam has achieved significant reductions in its malaria caseload over the past decades and is progressing towards malaria elimination. To achieve malaria elimination, the Vietnam Ministry of Health issued Guidelines for Malaria Surveillance and Prevention, a surveillance guide that describes malaria reactive surveillance and response (RASR) strategies—its implementation—is yet to be evaluated. Here, the facilitators, barriers and acceptability of the implementation of RASR strategies in Vietnam are explored and discussed thoroughly to provide recommendations for improvement of RASR strategies.Methods A mixed-methods study was conducted in Binh Thuan and Phu Yen Provinces in Vietnam from November 2021 to April 2022 including quantitative surveys with health stakeholders and staff (n=36) and frontline health service providers (n=38), qualitative focus group discussions with frontline health service providers and mobile migrant populations (n=70) and semistructured in-depth interview with health stakeholders and staff (n=28). Quantitative and qualitative data were analysed descriptively and thematically.Results Vietnam’s health system supports RASR strategies, and the RASR implementation data are well captured in the electronic communicable disease surveillance system of the Ministry of Health. Overall, RASR strategies are acceptable to both stakeholders and community members. However, successful implementation of RASR strategies is hindered by declining community interest in malaria elimination programme and limitations of infrastructure, budget, human resources, and terrain difficulties.Conclusions Overall health system support and policy commitment are key to successful implementation of RASR strategies and therefore for achieving malaria elimination. Despite high-performance and well-accepted RASR strategies, more financial and human resource investments are warranted to investigate and respond to all malaria foci in time. Village health workers could be used effectively to engage community members and mobile migrant populations in RASR activities.

Objectives To achieve malaria elimination by 2030, the Lao People’s Democratic Republic (PDR) adopted a reactive surveillance and response (RASR) strategy of malaria case notification within 1 day, case investigation and classification within 3 days and foci investigation and response within 7 days. It is important to evaluate the performance and feasibility of RASR implementation in Lao PDR so that the strategy may be optimised and better contribute towards the goal of malaria elimination.Design A mixed-methods study comprising of secondary data analysis of routinely collected malaria surveillance data, quantitative surveys and qualitative consultations was conducted in 2022.Setting Primary data collections for quantitative surveys and qualitative consultations were conducted in Huaphan, Khammouane, Luangprabang and Savannakhet Provinces of Lao PDR.Participants Quantitative surveys were conducted among malaria programme stakeholders and service providers. Qualitative interviews were conducted with malaria programme stakeholders, and focus group discussions with malaria programme stakeholders, service providers and mobile and migrant populations (MMPs).Outcome measures Outcomes of interests were awareness and acceptability of current RASR activities by different group of participants, implementation, performance and feasibility of RASR activities including enablers and barriers.Results In Lao PDR, malaria programme stakeholders and service providers were aware of RASR; however, these activities were not well known in MMPs. Respectively, the timeliness of case notification and case investigation was 0.0% and 15.6% in 2018 but increased to 98.0% and 98.6% in 2022. Implementation of RASR was acceptable to the malaria programme stakeholders and service providers, and continued implementation was perceived as feasible. Nevertheless, issues such as low level of community awareness, high level of migration and limitations in health system capacity were identified.Conclusion Overall, the timeliness of case notification and investigation in Lao PDR was high, and malaria programme stakeholders and service providers had positive opinions on RASR. However, some operational and health system-related barriers were identified, which need to be addressed to improve the performance of RASR in Lao PDR.

Abstract Background To enhance malaria elimination, Vietnam adopted a Reactive Surveillance and Response (RASR) Strategy in which malaria case notification and investigation must be completed within 2 days followed by a focus investigation within 7 days. The nationwide performance of Vietnam’s RASR strategy has yet to be evaluated. This study aims to evaluate the performance and feasibility of RASR in Vietnam, thereby providing recommendations for improved RASR. Methods To assess malaria RASR in Vietnam, a mixed-methods study of (1) secondary data analysis of nationwide malaria case-based dataset from 2017 to 2021; (2) a quantitative survey, and (3) qualitative in-depth interviews and focus group discussions administered to central, provincial and district level stakeholders/staff and to the commune and community level front line health services providers was conducted. Results In Vietnam, there are guidelines and procedures for implementation of each step of RASR. The completeness of case notification on the reported monthly aggregated data was very high in both the paper-based (12,463/12,498, 99.7% in 2017–2020) and electronic reporting systems (467/467, 100% in 2021 when electronic reporting was introduced); however, there were delays in notification while using the paper-based system (timely notification—7,978/12,498, 63.8%). In 2021, the completeness (453/467, 97.0%) and timeliness (371/467, 79.4%) of case investigation were found to be high. Reactive case detection was the major focus investigation response, with fever screening achievement of 88.6% (11,481 / 12,965) and 88.5% (11,471 / 12,965) among index case and neighbouring household members, respectively. Conclusions Overall, there was policy commitment for implementation of RASR in Vietnam. The completeness and timeliness of case notification and case investigation were high and improved after the introduction of the electronic reporting system. More evidence is required for reactive case detection in defining the screening area or population.