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The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar

BACKGROUND: Improving access to early diagnosis and treatment (EDT) has increasingly proven to be a major contributor to decreasing malaria incidence in low-transmission settings. The Malaria Elimination Task Force (METF) has deployed malaria posts set up in Eastern Myanmar, providing free uninterru...

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Autores principales: Rae, Jade D., Nosten, Suphak, Proux, Stéphane, Myint Thu, Aung, Cho, Win Cho, Paw, K’Nyaw, Paw, Eh Shee, Shee, Paw Bway, Be, Saw Aye, Dah, Saw Hsa, Moo, Saw Ku Ler, Minh, Saw Myo Chit, Shee, Paw Wah, Wiladphaingern, Jacher, Tun, Saw Win, Kajeechiwa, Ladda, Thwin, May Myo, Delmas, Gilles, Nosten, François H., Landier, Jordi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387481/
https://www.ncbi.nlm.nih.gov/pubmed/30795764
http://dx.doi.org/10.1186/s12936-019-2677-2
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author Rae, Jade D.
Nosten, Suphak
Proux, Stéphane
Myint Thu, Aung
Cho, Win Cho
Paw, K’Nyaw
Paw, Eh Shee
Shee, Paw Bway
Be, Saw Aye
Dah, Saw Hsa
Moo, Saw Ku Ler
Minh, Saw Myo Chit
Shee, Paw Wah
Wiladphaingern, Jacher
Tun, Saw Win
Kajeechiwa, Ladda
Thwin, May Myo
Delmas, Gilles
Nosten, François H.
Landier, Jordi
author_facet Rae, Jade D.
Nosten, Suphak
Proux, Stéphane
Myint Thu, Aung
Cho, Win Cho
Paw, K’Nyaw
Paw, Eh Shee
Shee, Paw Bway
Be, Saw Aye
Dah, Saw Hsa
Moo, Saw Ku Ler
Minh, Saw Myo Chit
Shee, Paw Wah
Wiladphaingern, Jacher
Tun, Saw Win
Kajeechiwa, Ladda
Thwin, May Myo
Delmas, Gilles
Nosten, François H.
Landier, Jordi
author_sort Rae, Jade D.
collection PubMed
description BACKGROUND: Improving access to early diagnosis and treatment (EDT) has increasingly proven to be a major contributor to decreasing malaria incidence in low-transmission settings. The Malaria Elimination Task Force (METF) has deployed malaria posts set up in Eastern Myanmar, providing free uninterrupted community-based access to EDT in more than 1200 villages. Ensuring high quality services are provided by these malaria posts is essential to reaching elimination targets. The present study aimed to determine the functionality of the malaria posts in the METF programme. METHODS: This report analysed routinely collected data (weekly reports, individual consultation, diagnostic test quality control) and data collected specifically during monitoring and evaluation visits using descriptive statistics and univariate logistic regression. The presence of major dysfunctions (stock-outs and reported closing; likely to impair the ability of the population to access EDT) or minor dysfunctions (no formal METF training, lack of regular salary, forms and manual not on-site, and low frequency of supervisor visits) and the ability to anticipate dysfunctions through analysis of weekly reports were assessed. RESULTS: A total of 65% of malaria posts had no major dysfunction identified during monitoring and evaluation visits, while 86% of malaria posts were fully stocked with tests and medicines used for treatment. Diagnosis was correctly conducted with few false positives and rare mis-speciation of results. Malaria post worker knowledge of malaria treatments showed few gaps, mostly in the treatment of more complex presentations. Malaria posts were well utilized in the population, with 94% of consultations occurring within the first 3 days of fever. In the regression analysis, reported stock-outs and delayed weekly reports were associated with observed major and minor dysfunctions in monitoring and evaluation visits, emphasizing the need to reinforce support to malaria post supervisors, who were responsible for the local logistics of supply and data transmission and day-to-day supervision. CONCLUSION: The malaria posts operating under the METF programme perform to a high standard, with the majority offering uninterrupted access to diagnosis and treatment, and high service uptake in the villages serviced by the programme. However, programme operations can be strengthened by increasing malaria post supervisor visits and re-training malaria post workers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12936-019-2677-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-63874812019-03-04 The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar Rae, Jade D. Nosten, Suphak Proux, Stéphane Myint Thu, Aung Cho, Win Cho Paw, K’Nyaw Paw, Eh Shee Shee, Paw Bway Be, Saw Aye Dah, Saw Hsa Moo, Saw Ku Ler Minh, Saw Myo Chit Shee, Paw Wah Wiladphaingern, Jacher Tun, Saw Win Kajeechiwa, Ladda Thwin, May Myo Delmas, Gilles Nosten, François H. Landier, Jordi Malar J Research BACKGROUND: Improving access to early diagnosis and treatment (EDT) has increasingly proven to be a major contributor to decreasing malaria incidence in low-transmission settings. The Malaria Elimination Task Force (METF) has deployed malaria posts set up in Eastern Myanmar, providing free uninterrupted community-based access to EDT in more than 1200 villages. Ensuring high quality services are provided by these malaria posts is essential to reaching elimination targets. The present study aimed to determine the functionality of the malaria posts in the METF programme. METHODS: This report analysed routinely collected data (weekly reports, individual consultation, diagnostic test quality control) and data collected specifically during monitoring and evaluation visits using descriptive statistics and univariate logistic regression. The presence of major dysfunctions (stock-outs and reported closing; likely to impair the ability of the population to access EDT) or minor dysfunctions (no formal METF training, lack of regular salary, forms and manual not on-site, and low frequency of supervisor visits) and the ability to anticipate dysfunctions through analysis of weekly reports were assessed. RESULTS: A total of 65% of malaria posts had no major dysfunction identified during monitoring and evaluation visits, while 86% of malaria posts were fully stocked with tests and medicines used for treatment. Diagnosis was correctly conducted with few false positives and rare mis-speciation of results. Malaria post worker knowledge of malaria treatments showed few gaps, mostly in the treatment of more complex presentations. Malaria posts were well utilized in the population, with 94% of consultations occurring within the first 3 days of fever. In the regression analysis, reported stock-outs and delayed weekly reports were associated with observed major and minor dysfunctions in monitoring and evaluation visits, emphasizing the need to reinforce support to malaria post supervisors, who were responsible for the local logistics of supply and data transmission and day-to-day supervision. CONCLUSION: The malaria posts operating under the METF programme perform to a high standard, with the majority offering uninterrupted access to diagnosis and treatment, and high service uptake in the villages serviced by the programme. However, programme operations can be strengthened by increasing malaria post supervisor visits and re-training malaria post workers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12936-019-2677-2) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-22 /pmc/articles/PMC6387481/ /pubmed/30795764 http://dx.doi.org/10.1186/s12936-019-2677-2 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Rae, Jade D.
Nosten, Suphak
Proux, Stéphane
Myint Thu, Aung
Cho, Win Cho
Paw, K’Nyaw
Paw, Eh Shee
Shee, Paw Bway
Be, Saw Aye
Dah, Saw Hsa
Moo, Saw Ku Ler
Minh, Saw Myo Chit
Shee, Paw Wah
Wiladphaingern, Jacher
Tun, Saw Win
Kajeechiwa, Ladda
Thwin, May Myo
Delmas, Gilles
Nosten, François H.
Landier, Jordi
The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar
title The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar
title_full The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar
title_fullStr The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar
title_full_unstemmed The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar
title_short The role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in Eastern Myanmar
title_sort role of monitoring and evaluation to ensure functional access to community-based early diagnosis and treatment in a malaria elimination programme in eastern myanmar
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387481/
https://www.ncbi.nlm.nih.gov/pubmed/30795764
http://dx.doi.org/10.1186/s12936-019-2677-2
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