Subnational Tailoring (SNT)

What is SNT?

Subnational Tailoring (SNT) is a strategic approach that enables malaria programs to move beyond “one-size-fits-all” solutions. It is the process of using local data and contextual information to determine the appropriate combinations of interventions and strategies for specific geographical areas—such as a district or health facility catchment—rather than applying a uniform national policy.

SNT is not a standalone project; it is an integral part of the national malaria strategic planning cycle. By bridging broad national goals with localized action, SNT ensures that the right tools are deployed in the right places, at the right times, and for the right populations. The ultimate goal is to achieve the maximum possible reduction in malaria morbidity and mortality within the context of value-based health care.

Core Principles of SNT

The SNT process is guided by evidence and adaptability. It relies on four pillars:

• Data-driven stratification SNT begins with a granular view of the problem. It involves classifying geographical areas based on epidemiological data (such as parasite prevalence and clinical incidence) and their determinants. This stratification transforms raw data into meaningful risk categories—High, Moderate, Low, and Very Low—allowing decision-makers to “triage” districts and target them with the appropriate intensity of response.
• Context-specific intervention mixes there is no single “silver bullet” for malaria. SNT involves selecting a customized package of interventions—ranging from vector control (like ITNs or IRS) to chemoprevention (like SMC or PMC) and vaccines—tailored to the specific transmission setting. This principle ensures that strategies address local realities, such as vector behavior, health system readiness, and acceptance by the community.
• Cost-aware decision-making strategic plans must be realistic. SNT integrates mathematical modeling and cost-effectiveness analysis to forecast the impact of different scenarios. It enables programs to prioritize interventions based on available funding, ensuring that the chosen strategies are not only impactful but also affordable and sustainable.
• Program ownership and equity SNT is inherently country-led. It requires strong national leadership and inclusive decision-making that involves stakeholders from government, civil society, and technical partners. Furthermore, the process is designed to promote equity, ensuring that interventions reach the most vulnerable and underserved populations, regardless of where they live.