Frequently Asked Questions about MDAST
What are the aims and planned outcomes of the MDAST project?
The Malaria Decision Analysis Support Tool (MDAST) project has sought to improve the protection of human health and the environment by promoting sustainable malaria control strategies that are consistent with the successful implementation of the Stockholm Convention on Persistent Organic Pollutants (POPs). The aim of MDAST is to promote evidence-based, multi-sectoral malaria control policy-making in Kenya, Tanzania, and Uganda, with the project serving as pilot for other malaria-prone countries. The MDAST framework simultaneously considers multiple outcomes and attributes of various combinations of malaria control options, including both ecological and human health risks and benefits.
To accomplish this goal, the project focused on achieving four main outcomes:
(1) Development of a Malaria Decision Analysis Support Tool (MDAST) that jointly incorporates health, social and environmental priorities for malaria control in Kenya, Tanzania, and Uganda.
(2) Increased capacity for evidence-based malaria control policy making through the use of MDAST in Kenya, Tanzania, and Uganda.
(3) Creation of an agenda for policy-relevant malaria research through development of MDAST and identification of key knowledge gaps.
(4) Elucidation of requirements for replication of MDAST in other malaria-prone countries around the world.
Who are the project partners of MDAST?
This project was funded by the Global Environment Facility (GEF) in collaboration with the United Nations Environment Programme (UNEP) which served as the GEF Implementing Agency. The World Health Organization (WHO) served as the GEF Executing Agency. The project was accomplished through strong partnerships among WHO-AFRO and the five collaborating institutions (Duke University- Duke Global Health Institute, University of Pretoria – School of Health Systems and Public Health, Ministry of Health (Kenya) – Division of Malaria Control, National Institute of Medical Research – Tanzania), and the Ministry of Health (Uganda)- Vector Control Division.
In what ways did in-country stakeholders participate in the development of MDAST?
The most essential component for realizing the value of MDAST is the involvement and commitment of in-country stakeholders from a range of government sectors as well as other relevant private and non-profit organizations, especially implementers and policy-makers involved in malaria control. Input from stakeholder engagement activities has been a key element behind the iterative process of tool development and refinement. The process of gaining and incorporating stakeholder feedback has also been instrumental in building understanding and a sense of ownership among the stakeholders. Project partners worked together closely to coordinate a range of country-specific stakeholder engagement activities that furthered the user-driven development of MDAST for Tanzania, Kenya, and Uganda. This included convening a project inception meeting, conducting and analyzing a stakeholder survey, webinars, expert consultations, and running stakeholder workshops and trainings in each of the three project countries.
What are the past, current, and future training opportunities for potential users of MDAST?
- The MDAST Demonstration and Training Workshops held in April 2012 in Kenya, Uganda, and Tanzania engaged a range of stakeholders in the review and initial use of the tool. In the hands-on training session, participants were guided through developing, implementing, and interpreting a number of scenarios using the model. In a feedback questionnaire, stakeholders reported an overwhelmingly positive increase in their interest and motivation to use MDAST as a result of the training sessions.
- The MDAST website ( http://sites.duke.edu/mdast/ ) provides a number of training resources and opportunities for users, including:
- The MDAST User Manual, which provides a detailed description and guide to the use of the MDAST tool, including examples. The latest version of the MDAST User Manual is available on the MDAST website at http://sites.duke.edu/mdast/manual/ .
- MDAST demonstration videos, available at http://sites.duke.edu/mdast/updates/ .
- User discussion forums for exchanging tips, thoughts, and troubleshooting
- Project partners are currently seeking additional resources for continued training activities.
What are the data requirements for using MDAST?
The MDAST model calculates the outcomes of alternative health delivery strategy by combining parameters describing the malaria context with the health delivery decisions to generate estimates of the economic impacts, human health impacts, and environmental impacts. MDAST can operate with reasonable defaults (based on the literature) if the user cannot provide the contextual data for given parameters because of constraints on data availability or quality.
How can I interpret the results / output from MDAST? How can I know which is the “best” scenario?
The User Manual provides guidance on interpretation of results. However, it should be noted that while MDAST is meant to be used as a tool to compare alternative user-defined scenarios, it does not attempt to identify the “best” option, which will depend on many factors. The tool provides a way to compare the outputs which the user must interpret taking into consideration which results are most important for his or her given context and purpose.
At what level should MDAST be applied?
MDAST may be used to examine scenarios at various levels, but the contextual policy environment should inform the most appropriate level for its use. Stakeholders generally agreed that while district-level data could be valuable in reflecting and addressing varied situations across the country, ultimately the tool would have to be introduced and used in a way that was consistent with the established organizational structures for policymaking and implementation in the country.
Are there plans to expand MDAST to other contexts and countries?
MDAST project partners are actively exploring funding opportunities and avenues for replication activities in other countries. The project partners have developed guidelines on the successful dissemination and implementation of MDAST in other countries affected by malaria (these guidelines are presented on pages 28 – 33 within the MDAST Final Report, available at http://sites.duke.edu/mdast/files/2013/12/Final-Report.pdf ).