Good clinical practice in managing malaria requires awareness and understanding of national case management guidelines. Moumouni Bonkoungou, Ousmane Badolo, and Thierry Ouedraogo of Jhpiego in Collaboration with the National Malaria Control Program and sponsorship from the “Improving Malaria Care” project of USAID/PMI explain how health workers in Burkina Faso were oriented to the national guidelines at the 66th Annual Meeting of the American Society of Tropical Medicine and Hygiene. They have found that short orientations are less expensive and reach more health workers that traditional training sessions.
Malaria remains the leading cause of consultations, hospitalization and death in health facilities in Burkina Faso. In 2015, 23,634 cases of severe malaria were recorded in hospitals with 1,634 deaths, a mortality rate of 7% at this level compared to 1% nationally. Since April 2014, 1,819 providers from 49 districts have been trained in malaria case management, specifically at the first level (health center – CSPS). Conversely, at referral centers – medical centers with surgical units (CMA), regional hospitals (CHR) and university hospitals (CHU) – providers are not well educated on the new WHO guidelines for malaria prevention and case management.
This situation led the United States Agency for International Development-supported Improving Malaria Care (IMC) project and the National Malaria Control Program (NMCP) to organize orientation sessions for providers in 8 CHR in September 2016. The sessions were conducted by trainers at the national level, supported by clinicians from hospitals including pediatricians and gynecologists.
A total of 298 health workers were oriented, including 24 physicians, 157 nurses, 56 midwives, as well as pharmacists and laboratory technicians. 39% of participants were female and 43% have less than 5 years of service in these hospitals. The sessions have provided participants with an opportunity to familiarize themselves with the new guidelines for malaria prevention and case management.
The orientations have also made it possible to identify the difficulties encountered by referral structures in malaria case management, which include: insufficient staff, inadequate capacity building, no blood bank in some hospitals, reagent stock-outs, inadequacies in the referral system, and insufficient equipment.
To address these difficulties, staff redeployment, internal supervision, development of tools to monitor reagents stocks have been proposed. To move forward, response plans for the period of high malaria transmission is expected to be developed for these referral facilities.