Uncertainties around deforestation influences on vector-borne disease transmission and prevalence means that varieties of forest management techniques must be included in evaluations of health management policies.

This commentary presents ideas for improving malaria management policy in marginal communities, where both elimination of health inequalities and mangrove restoration are desirable interventions. It relies on results of novel application of Qualitative Comparative Analysis (QCA) on causal relationships influencing malaria incidence in Ghana. Restoration-related mangrove conditions were investigated alongside the predominant vector control strategies.

QCA findings show ecological conditions of temperature reduction, improved water quality, arrest of mangrove land conversion and presence of biological control agents combining diversely to amplify impacts of personal protective measures, especially insecticide treated net usage. The viewpoint is that ecosystem and health mangers must collaborate in capacity building, trend monitoring and creation of new knowledge to ensure that cross-sector benefits are sufficiently addressed in policy reforms. Further research required to reveal how mangrove presence and/or restoration affect malaria parasite prevalence and transmission dynamics in mangrove mosquitoes, to identify pathways for modifying and tailoring vector-control strategies to suit needs in mangrove communities.

QCA could be a valuable causal inference technique for bringing clarity to nature-health relationships because it makes room for analysis of 'conjunctural' impacts of non-nature conditions.