Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018
Abstract Background Madagascar’s Malaria National Strategic Plan 2018–2022 calls for progressive malaria elimination beginning in low-incidence districts (< 1 case/1000 population). Optimizing access to prompt diagnosis and quality treatment and improving outbreak detection and response will be c...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-020-03417-z |
| _version_ | 1818162075390705664 |
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| author | Anjoli Anand Rachel Favero Catherine Dentinger Andrianandraina Ralaivaomisa Sitraka Ramamonjisoa Oliva Rabozakandraina Eliane Razafimandimby Jocelyn Razafindrakoto Katherine Wolf Laura Steinhardt Patricia Gomez Malanto Rabary Mauricette Nambinisoa Andriamananjara Sedera Aurélien Mioramalala Jean-Pierre Rakotovao |
| author_facet | Anjoli Anand Rachel Favero Catherine Dentinger Andrianandraina Ralaivaomisa Sitraka Ramamonjisoa Oliva Rabozakandraina Eliane Razafimandimby Jocelyn Razafindrakoto Katherine Wolf Laura Steinhardt Patricia Gomez Malanto Rabary Mauricette Nambinisoa Andriamananjara Sedera Aurélien Mioramalala Jean-Pierre Rakotovao |
| author_sort | Anjoli Anand |
| collection | DOAJ |
| description | Abstract Background Madagascar’s Malaria National Strategic Plan 2018–2022 calls for progressive malaria elimination beginning in low-incidence districts (< 1 case/1000 population). Optimizing access to prompt diagnosis and quality treatment and improving outbreak detection and response will be critical to success. A malaria elimination readiness assessment (MERA) was performed in health facilities (HFs) of selected districts targeted for malaria elimination. Methods A mixed methods survey was performed in September 2018 in five districts of Madagascar. Randomly selected HFs were assessed for availability of malaria commodities and frequency of training and supervision conducted. Health providers (HPs) and community health volunteers (CHVs) were interviewed, and outpatient consultations at HFs were observed. To evaluate elimination readiness, a composite score ranging from 0 to 100 was designed from all study tools and addressed four domains: (1) resource availability, (2) case management (CM), (3) data management and use, and (4) training, supervision, and technical assistance; scores were calculated for each HF catchment area and district based on survey responses. Stakeholder interviews on malaria elimination planning were conducted at national, regional and district levels. Results A quarter of the 35 HFs surveyed had no rapid diagnostic tests (RDTs). Of 129 patients with reported or recorded fever among 300 consultations observed, HPs tested 56 (43%) for malaria. Three-quarters of the 35 HF managers reviewed data for trends. Only 68% of 41 HPs reported receiving malaria-specific training. Of 34 CHVs surveyed, 24% reported that treating fever was no longer among their responsibilities. Among treating CHVs, 13 (50%) reported having RDTs, and 11 (42%) had anti-malarials available. The average district elimination readiness score was 52 out of 100, ranging from 48 to 57 across districts. Stakeholders identified several challenges to commodity management, malaria CM, and epidemic response related to lack of training and funding disruptions. Conclusion This evaluation highlighted gaps in malaria CM and elimination readiness in Madagascar to address during elimination planning. Strategies are needed that include training, commodity provision, supervision, and support for CHVs. The MERA can be repeated to assess progress in filling identified gaps and is a feasible tool that could be used to assess elimination targets in other countries. |
| first_indexed | 2024-12-11T16:27:54Z |
| format | Article |
| id | doaj.art-5a901a4a7e19474fbd0bd8129bf4cfb8 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-11T16:27:54Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-5a901a4a7e19474fbd0bd8129bf4cfb82022-12-22T00:58:40ZengBMCMalaria Journal1475-28752020-10-0119111410.1186/s12936-020-03417-zMalaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018Anjoli Anand0Rachel Favero1Catherine Dentinger2Andrianandraina Ralaivaomisa3Sitraka Ramamonjisoa4Oliva Rabozakandraina5Eliane Razafimandimby6Jocelyn Razafindrakoto7Katherine Wolf8Laura Steinhardt9Patricia Gomez10Malanto Rabary11Mauricette Nambinisoa Andriamananjara12Sedera Aurélien Mioramalala13Jean-Pierre Rakotovao14Epidemic Intelligence Service, Centers for Disease Control and PreventionMaternal Child Survival ProgramMalaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and PreventionMaternal Child Survival ProgramMaternal Child Survival ProgramIndependent ConsultantMaternal Child Survival ProgramUS President’s Malaria Initiative, US Centers for Disease Control and PreventionMaternal Child Survival ProgramMalaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and PreventionMaternal Child Survival ProgramIndependent ConsultantNational Malaria Control Programme, Ministry of HealthNational Malaria Control Programme, Ministry of HealthMaternal Child Survival ProgramAbstract Background Madagascar’s Malaria National Strategic Plan 2018–2022 calls for progressive malaria elimination beginning in low-incidence districts (< 1 case/1000 population). Optimizing access to prompt diagnosis and quality treatment and improving outbreak detection and response will be critical to success. A malaria elimination readiness assessment (MERA) was performed in health facilities (HFs) of selected districts targeted for malaria elimination. Methods A mixed methods survey was performed in September 2018 in five districts of Madagascar. Randomly selected HFs were assessed for availability of malaria commodities and frequency of training and supervision conducted. Health providers (HPs) and community health volunteers (CHVs) were interviewed, and outpatient consultations at HFs were observed. To evaluate elimination readiness, a composite score ranging from 0 to 100 was designed from all study tools and addressed four domains: (1) resource availability, (2) case management (CM), (3) data management and use, and (4) training, supervision, and technical assistance; scores were calculated for each HF catchment area and district based on survey responses. Stakeholder interviews on malaria elimination planning were conducted at national, regional and district levels. Results A quarter of the 35 HFs surveyed had no rapid diagnostic tests (RDTs). Of 129 patients with reported or recorded fever among 300 consultations observed, HPs tested 56 (43%) for malaria. Three-quarters of the 35 HF managers reviewed data for trends. Only 68% of 41 HPs reported receiving malaria-specific training. Of 34 CHVs surveyed, 24% reported that treating fever was no longer among their responsibilities. Among treating CHVs, 13 (50%) reported having RDTs, and 11 (42%) had anti-malarials available. The average district elimination readiness score was 52 out of 100, ranging from 48 to 57 across districts. Stakeholders identified several challenges to commodity management, malaria CM, and epidemic response related to lack of training and funding disruptions. Conclusion This evaluation highlighted gaps in malaria CM and elimination readiness in Madagascar to address during elimination planning. Strategies are needed that include training, commodity provision, supervision, and support for CHVs. The MERA can be repeated to assess progress in filling identified gaps and is a feasible tool that could be used to assess elimination targets in other countries.http://link.springer.com/article/10.1186/s12936-020-03417-zMalaria eliminationMalaria control programmeHealth facility survey |
| spellingShingle | Anjoli Anand Rachel Favero Catherine Dentinger Andrianandraina Ralaivaomisa Sitraka Ramamonjisoa Oliva Rabozakandraina Eliane Razafimandimby Jocelyn Razafindrakoto Katherine Wolf Laura Steinhardt Patricia Gomez Malanto Rabary Mauricette Nambinisoa Andriamananjara Sedera Aurélien Mioramalala Jean-Pierre Rakotovao Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018 Malaria Journal Malaria elimination Malaria control programme Health facility survey |
| title | Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018 |
| title_full | Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018 |
| title_fullStr | Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018 |
| title_full_unstemmed | Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018 |
| title_short | Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018 |
| title_sort | malaria case management and elimination readiness in health facilities of five districts of madagascar in 2018 |
| topic | Malaria elimination Malaria control programme Health facility survey |
| url | http://link.springer.com/article/10.1186/s12936-020-03417-z |
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