Strengthening Quality of Malaria Diagnostics in Counties

Accurate early diagnosis as well as prompt treatment of Malaria is among the vital approaches for preventing, controlling and reducing mortality.

In Kenya, there are an estimated 3.5 million new clinical cases and 10,700 deaths each year, and those living in Western Kenya have a higher risk of malaria (Centers for Disease Control, 2018).

Amref Health Arica’s Institute of Capacity Development (ICD) supports six endemic zones in Kenya- Bungoma, Kakamega, Busia, Siaya, Homabay and Migori. The programme, supported by  GlaxoSmithKline (GSK), implements evidence-based malaria interventions as well as leadership and technical capacity training in the prevention, diagnosis, treatment, surveillance, monitoring and evaluation of Malaria.

A notable and comprehensive achievement recently documented by the programme in Bungoma County was the improvement of the capacity of healthcare workers for effective prevention, screening, timely diagnosis and case management of Malaria.

According to Philip Chesire, the Coordinator of Malaria Quality Assurance in Bungoma County,

 one of the intermediate results was an improvement in quality Malaria diagnostics. “Initially, malaria was diagnosed without any roadmap and the quality of malaria diagnosis was not given preference,” says Chesire.

To address this challenge, given that Bungoma is among the counties with the highest prevalence of malaria, the GSK programme prioritised capacity building for health workers.

“We were taken through a series of training that has helped us to transform the management of malaria in the county,” he attests. “We have strengthened the support supervision in link facilities that have contributed to the usage of commodities and documentation with an aim to improve the accuracy of malaria diagnostics at link facilities.”

Although Bungoma County has made some progress in improving malaria control and management, it remains the third largest contributor of malaria cases in Kenya with a prevalence rate of 15.2% (Kenya Malaria Indicator Survey, 2021).

Everlyne Mulati, Medical Lab Technologist, Bungoma County Referral hospital, Pediatric Lab was among 19 Laboratory Technicians/Technologists trained on Quality Assurance and Malaria Microscopy training supported by Amref Health Africa’s GSK programme.

Many times, she struggled to make informed decisions due to a lack of quality diagnostics. “After the training, I realised what I was doing was not quality testing. I could not identify malaria parasites well and could not do internal quality control,” she says.

An accurate and timely diagnosis of malaria improves control measures and reduces morbidity and mortality.

“After training, I am able to detect and quantify different stages of malaria parasites,” Everlyne reaffirms. She can also perform internal quality control microscopy diagnosis to improve the efficiency and accuracy of test results. 

A key tenet of malaria control is strengthening data collection and analysis capacity, which is also critical for malaria elimination. This contributes to better decisions which drive programme performance and outcomes.

“The training improved our overall knowledge and skills in data analytics and it enabled us use the data in decision making for programmatic to policy level at the county as well national,” said Simon. “The management in hospitals have to use the data to get commodities from Kenya Medical Supplies Authority (KEMSA) and other suppliers.”

Simon was trained on Malaria surveillance, monitoring, evaluation, operational research and use of data for planning and decision-making and he has supported his colleagues with on-the-job training and mentorship on data analysis and utilisation.

The GSK project is working under seven pillars: Leadership and Governance, Financing, Human Resource for Health (HRH), Health Information System, Service Delivery, Medical Products – Vaccines and Technologies as well as demand for and uptake of services. With this multi-tiered approach, the project has trained 560 Healthcare workers from the six target counties.

Maureen Cherongis, Communications Officer, Amref Health Africa.