Outreach training and supportive supervision for malaria case management in Zambia: the effects of focused capacity building on indicators of diagnostic and clinical performance

• Published in: Malaria journal 2018-11, Vol.17 (1), p.438-438, Article 438
• Main Authors: Worges, Matt, Whitehurst, Nicole, Yamo, Emanuel, Moonga, Hawela, Yukich, Joshua, Benavente, Luis
• Format: Article
• Language: English
• Subjects: Analysis; Best practices; Blood; Capacity Building; Capacity development; Care and treatment; Case Management; Clinical; Data collection; Diagnosis; Diagnostic tests; Diagnostics; Fever; Health Education; Health facilities; Human diseases; Humans; Infrastructure; Laboratories; Malaria; Malaria - diagnosis; Malaria - drug therapy; Medical personnel training; Microscopy; Parasites; Preceptorship - methods; Preceptorship - organization & administration; Primary care; Public health; Quality assurance; Quality Assurance, Health Care - organization & administration; Quality control; Reagents; Slide preparation; Stock assessment; Supervision; Supplies; Supportive supervision; Systematic review; Training; Vector-borne diseases; Zambia
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-018-2589-6

Accurate diagnosis of malaria and reduced reliance on presumptive treatment are crucial components of quality case management. From 2008 to 2012, the Improving Malaria Diagnostics project, in collaboration with the Zambia National Malaria Control Centre, implemented an external quality assurance scheme partially comprised of outreach training and supportive supervision (OTSS) in an effort to improve malaria case management across a spectrum of health facilities performing laboratory-based malaria diagnostics. OTSS assessments were conducted by project-trained laboratory and clinical supervisors on a regular basis and measured changes in health facility staff performance over time. Standardized supervision tools were used for data collection and guided OTSS teams to assess health facility infrastructure, record keeping practices, stores of supplies and consumables, good laboratory practices, and staff adherence to guidelines for the case management and diagnosis of suspected malaria cases via direct observations or record reviews. The structure of OTSS also allowed supervisors to provide ongoing support to clinicians and laboratory staff through regular mentoring and on-the-job training. This analysis included 88 laboratories and 64 clinics each with four repeated supervisory assessments. Over the course of the project there were significant declines in the number of laboratories experiencing stock-outs of microscopy reagents/consumables (p