Strengthening capacity in high-burden malaria-endemic countries: a strategic analysis of training gaps and blended learning solutions in national malaria control programs

Abstract Background Malaria remains a significant public health challenge, with approximately 70% of the disease burden concentrated in 11 High-Burden to High-Impact (HBHI) countries identified by the World Health Organization. Despite substantial investments in interventions including insecticide-treated nets, rapid diagnostic tests, artemisinin-based combination therapy, and vaccines, persistent human resource capacity deficiencies undermine the effectiveness and sustainability of malaria control. Training gaps affect community health workers, district officials, and national program managers across various areas, including diagnostics, case management, surveillance, and data analytics. Methods This mixed-methods analysis integrated peer-reviewed literature, WHO and donor agency reports, and case studies from HBHI countries. Data from national health information systems and malaria program reports were evaluated using an Impact-Feasibility Matrix, with systemic relationships mapped across community, district, and national levels. Recommendations were validated through consultations with technical experts, Malaria Policy Advisory Group members, National Malaria Control Program managers, and partner organizations. Results Significant training and workforce shortages were identified at all health system levels. Community-level deficiencies in health worker training and supervision correlated with misdiagnosis, treatment delays, and poor community engagement. District challenges included suboptimal supply chain management, insufficient surveillance capacity, and limited managerial skills. National-level constraints involved inadequate technical expertise in epidemiology, data analysis, and policy adaptation. A blended learning strategy combining self-paced digital modules, virtual mentoring, and outreach training with supportive supervision emerged as a high-priority intervention. Implementation of standardized evaluation frameworks was recommended to assess training effectiveness across multiple outcome domains. Conclusions Enhancing workforce capacity through blended learning methodologies can effectively address critical human resource gaps in HBHI countries. Context-specific training, digital resources, and sustainable mentorship frameworks can significantly improve operational efficiency, service delivery, and strategic planning. Local capacity strengthening for best practice implementation at all health system levels is essential for achieving malaria elimination targets.