When ownership is not enough: Evaluating the co-development and uptake of the Options Assessment Toolkit (OAT) for Plasmodium vivax radical cure in malaria-endemic countries

IntroductionRadical cure of Plasmodium vivax malaria remains a major challenge in endemic countries. New treatment options add opportunities but also increase complexity of policy decisions. Malaria treatment policies are often shaped by World Health Organisation (WHO) guidance, limiting scope for local adaptation. The Options Assessment Toolkit (OAT) was developed to support national policy making for the radical cure of vivax malaria. This study evaluates its co-development, uptake and practical influence. MethodsWe conducted a qualitative study with stakeholders in Afghanistan, the Solomon Islands, and Vietnam (co-developers) and Nepal (new user context). In-depth interviews were conducte