Providing locally appropriate, effective case management interventions for all malaria patients is an important component of malaria control efforts. Malaria case management consists of early, accurate diagnosis and prompt treatment with a recommended antimalarial drug combination such as artemisinin-based combination therapies (ACT).
For decades, health providers working in malaria-endemic areas were taught that most children presenting with fever likely had malaria and should be treated for it. In those days, only microscopy was used for clinical diagnosis, but such services were not available in most settings. However, the situation changed significantly with the advent of low-cost rapid diagnostic tests (RDTs) for malaria.
In 2010, the World Health Organization issued new guidance calling for universal diagnostic testing (using RDTs or microscopy) and recommending that antimalarial treatment only be administered when a test is positive for malaria. MalariaCare champions this approach.
MalariaCare offers comprehensive technical support to USAID Mission and national government programs to expand high-quality diagnosis and treatment for malaria and other febrile illnesses. Our services include technical assistance on case management, monitoring and evaluation, and program management. We also work with governments on health policy and guidelines development for the management of malaria and other febrile illnesses. On the global level, the project assists the WHO in developing guidelines for malaria control, including participation in case management (diagnostics and treatment) and drug resistance working groups. In addition, we strive to share lessons learned and best practices gleaned during the project.
MalariaCare is focused on rapidly achieving high nationwide coverage of diagnosis and appropriate treatment. Our approach includes:
Expanding use of high-quality diagnostics: MalariaCare seeks to improve and promote accurate diagnosis of malaria in priority countries by facilitating expansion of parasitological testing – through quality assured and quality controlled malaria rapid diagnostic tests (RDTs) and malaria microscopy. We do this not only by assisting governments and private organizations in scaling up testing capacity, but also in assuring quality of results through development of a quality assurance framework. Together, this approach increases testing coverage and promotes confidence in test results throughout the health care system.
Fostering appropriate treatment of febrile illness: Through the use of appropriate diagnostics, the project also works to improve clinical treatment and outcomes. We work with governments and private organizations to develop clinician support systems – from tertiary reference centers to community level interventions – helping physicians, nurses, pharmacists, and community health workers to use malaria testing to better manage patients presenting with fever. This strategy improves management of malaria and other diseases characterized by fever, and focuses on appropriate use of effective malaria drugs. Patient care is improved through more appropriate treatment based on correct diagnosis, and health care resources are saved through a more focused use of expensive antimalarial medications and antibiotics.
Facilitating partnerships with private-sector organizations: MalariaCare recognizes the important role that the private sector plays in health systems, and seeks to improve diagnosis and treatment from private-sector providers—both for-profit and not-for-profit—including private clinics and hospitals, pharmacies, retail outlets, and community networks. The project aims to ensure that private providers receive support and supervision, and that they contribute to tracking and monitoring malaria diagnosis and treatment. In addition, where appropriate to improve patient care, MalariaCare seeks to strengthen cooperative mechanisms between the public and private sectors, and promote improved regulation of the private sector as part of a country’s health sector.
- Needs assessments and strategic planning. The partnership works with USAID Missions and country partners to identify current needs and create strategic plans conducive to achieving national malaria control goals.
- Policy development. Working at global, regional, and national levels, the partnership develops, updates, and advocates for policies, guidance, and tools based on current evidence and strategies for managing patients with fever in malaria-endemic areas.
- Implementation support. Our support includes strengthening staff training and supervision, assisting in data collection and analysis, and planning scale-up for impact.
- Systems strengthening. The partnership strengthens country capacity to leverage human, financial, and systems resources required to ensure success in achieving maximum diagnostics and treatment coverage with high quality.
- Public-private partnerships. MalariaCare engages with the private sector and promotes public-private partnerships to facilitate national improvements in malaria diagnosis and treatment.
- Monitoring and evaluation. Our work includes improving data collection systems to facilitate tracking and reporting on progress, along with training to use the data for effective, informed decision-making.
- Sharing best practices. MalariaCare applies country-based evidence and experience to inform best practices at global, regional, and country levels.
Photo: PATH/David Jacobs