Surveillance Barriers

Barriers are defined as obstacles that hinder malaria surveillance activities in community pharmacies and over-the-counter medicine sellers. Provider motivation to participate in surveillance is shaped by willingness, client requests, clinical judgement, personal conviction, desire to treat febrile illness, and sociocultural orientation. Provider-level barriers include increased workload, delayed service delivery, operational costs, client financial burden, and reduced business revenue. System-level barriers include limited awareness of reporting requirements, administrative burden, low motivation, and weak public-private coordination. The review anticipates that heterogeneity in outlet classification, regulatory scope, epidemiology, and surveillance architecture will complicate comparisons across countries.