Tanzania: An Exemplar in Malaria Subnational Tailoring

In 2015, Tanzania had a national malaria prevalence of 14.4% and set a goal to reduce it to 1% by 2020. By 2017, a strategy review found that prevalence had declined to just over 7%, reflecting substantial progress, though it remained above the target level. To accelerate progress toward the 1% goal, Tanzania adopted an approach known as subnational tailoring (SNT). Instead of deploying the same interventions across the country regardless of geographic differences in epidemiology, the objective of the SNT approach was to deliver the appropriate interventions to the right places at the right times.

The SNT approach required collecting a wide range of data describing conditions throughout Tanzania, analyzing that data to understand and forecast malaria-related trends at a granular level, and building a subnationally tailored implementation plan based on the evidence. At each stage in this process, Tanzania developed and implemented promising practices including:

• Intentional, participatory collaboration among the National Malaria Control Program, technical partners, funders, and subnational health management teams, which fostered a country-owned and executed SNT strategy.

• Effective data systems that enabled Tanzania to consolidate diverse, high-quality data sets that facilitated sophisticated evidence-based decision-making.

• Fully institutionalized SNT approach within the National Malaria Control Program and stratified intervention packages as the basis for budgeting and planning.

While Tanzania continues to fill gaps in its emerging SNT approach, it is already delivering results — for example, malaria case incidence declined from 123 cases per 1,000 population in 2019 to 53 cases per 1,000 population in 2024 — and its experiences can help guide the work of peer countries exploring SNT to accelerate malaria reductions.