Using the collaborative quality improvement approach to increase adherence to the test, treat, and track malaria case management framework: Experiences from 10 health facilities in Uganda

Malaria is a leading cause of morbidity and mortality in Uganda and in 2014 was responsible for:

• 19 percent of Uganda’s parasite prevalence
• 30-50 percent of outpatient visits
• 15-20 percent of hospital admissions
• 20 percent of inpatient deaths.[1]

In an effort to reduce its malaria burden, in 2016 the Ministry of Health in Uganda incorporated a number of World Health Organization recommendations into its National Malaria Policy Guidelines. The main recommendations implemented by health workers were:

• testing all suspected malaria cases with malaria rapid diagnostic tests (mRDT) or
microscopy before treatment
• using artemisinin-based combination therapy (ACT) to treat only positive malaria cases
• providing at least three doses of intermittent preventive treatment in pregnancy with
sulfadoxine-pyrimethamine (IPTp-SP).

However, a number of challenges for malaria service delivery were encountered during
implementation, including:

• incomplete, inaccurate, and inconsistent malaria records and reports
• health workers not adhering to the malaria test, treat, and track policy
• malaria causing high caseloads at outpatient and inpatient service points.

To overcome these issues, and in particular to improve adherence to the malaria test, treat and track policy and strengthen the quality of data collection and recording, USAID’s Malaria Action Program for Districts (MAPD) implemented a collaborative quality improvement approach (CQI). This presentation, which was presented at the 67th annual meeting of the American Society of Tropical Medicine and Hygiene, shares key findings from implementing the approach in Uganda.  

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