Bridging the policy-action gap: a scoping review of climate-resilient malaria control policies in Kenya and Zambia with recommendations for strengthening the WHO framework

Introduction Malaria remains a significant public health challenge in Kenya and Zambia, with climate change exacerbating its spread through altered rainfall patterns, temperature shifts, and extended mosquito breeding seasons. Both countries have implemented climate-resilient policies to mitigate malaria risks, including Kenya’s National Malaria Strategy and Zambia’s Climate Change and Health Action Plan. However, implementation gaps persist due to inadequate funding, weak enforcement, integrating and aligning actors to common malaria policies, and policy coordination challenges. This study explores the policy-action gaps on climate-resilient policies on malaria in Kenya and Zambia. Methods The study adopted extended literature review through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA model). The authors adopted an inclusion-exclusion criteria that captured peer-reviewed articles published since 2010. Literature search was through use of key words from leading scholarly sources, notably, Google Scholar, Web of Science, Science Direct, EBSCOhost, PubMed and African Journals Online. Thematic analysis was carried out. Policy documents were also reviewed and included. A summary table capturing the related climate-resilient policies was presented, along with supporting discussions. Results Of the 274 articles identified, nineteen articles were included in the review. Key policies were identified in the two countries, and their implementation gaps and potential challenges in their implementations. Some identified policy-action gaps were related to weak health system infrastructure, inadequate resource allocation, and limited integration of climate data into malaria response. Implementation challenges arise due to misalignment among actors, lack of intersectoral collaboration, and fragmented stakeholder engagement, hindering effective policy execution. Lastly, the absence of clear implementation metrics, well-defined responsibilities, and cross-cutting indicators in key policies weakens monitoring and evaluation, leading to inefficiencies in achieving malaria reduction targets. Conclusion The study concluded that significant policy-action gaps exist, which need strengthening multi-sectoral collaboration, integrating climate data into policies, adequate financial support, improving surveillance systems, and mainstreaming climate adaptation into malaria control programs for long-term success.