Lessons learned from the roll out of RDTs

In Uganda, Malaria Consortium Country Director reports that experience supports the roll out of RDTs country wide.

On 14 December, Malaria Consortium and the Uganda Ministry of Health hosted an event on the lessons learned from the roll out of rapid diagnostic tests for malaria (RDTs) over the past two years in nine districts of mid-western Uganda and made recommendations for the successful roll-out nationwide.

The meeting was opened by Dr. Opio, the Assistant Commissioner for national disease control who highlighted the importance of moving away from presumptive treatment and ensuring that all cases of fever are diagnosed through the use of RDTs or microscopy where available. Dr. Okui, programme manager of the National Malaria Control Programme (NMCP) chaired this event with support from Mr. Agaba Bosco, NMCP Diagnostics Specialist.

Based on Malaria Consortium’s experience of using RDTs at health facilities and the use of RDTs in communities by community health workers, locally referred to as Village Health Teams, four key areas were identified as needing special attention in order to successfully roll-out RDTs in the whole country: training, monitoring and support supervision, supply chain management, and sensitisation and behaviour change communication.

Ministry of Health officials, donors and implementing partners attended the meeting and shared their experiences while also asking key questions relating to the impact upon national guidelines and the use of RDTs. Presenters included the District Health Officer for Kyankwanzi district, a community health worker from Hoima District, central and district trainers as well as Malaria Consortium project managers.

Discussions focused on health worker and patient adherence to negative RDT results, external quality assurance, depth and length of training, use of RDTs by community health workers and waste management. Further discussions are needed on issues of procurement, stock re-distribution between the health facilities and the community health workers and the need for a push and pull system of supply management.

“There are a number of areas for improvement such as compliance by health workers and supply chain management but effective implementation is necessary in order to reduce wastage in treatment. It’s a cost worth investing in,” said Dr. Magumba, Malaria Consortium Uganda Country Director, in his closing remarks. “Rolling out RDTs across the whole country is the only way to go.”

Malaria Consortium strongly believes that RDT roll-out will only achieve the desired impact through the involvement of all stakeholders simultaneously addressing the following issues:

1. Appropriate training of health workers in in management of malaria and other febrile illnesses, in case of a negative RDT.

2. Support supervision tailored over time to improve and sustain quality of the services

3. Strong monitoring systems to improve disease surveillance; ensure the quality of the test kits and inform stock management

4. Sensitisation and social mobilisation to ensure uptake by health workers and community members

For more detailed information and data, please click here to read the RDT Learning Brief and the presentation.

For more information contact [email protected]

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Through two projects funded by Comic Relief and the Canadian International Development Agency, Malaria Consortium has pioneered the introduction of RDTs at community and health facility levels in nine districts of Mid-western Uganda. Between November 2009 and October 2011, Malaria Consortium trained more than 1,000 health workers and 6,700 VHTs on use and management of RDTs. In total, 126 health facilities and 3,350 villages are now using RDTs to diagnose malaria.

The event was hosted by Malaria Consortium and the Uganda Ministry of Health with the support of Comic Relief and UK aid