Malaria Diagnostic Service Availability – Mapping of Nigerian Private Sector Service Delivery Outlets

maps logoThis study was undertaken in seven US President’s Malaria Initiative supported Nigerian States through the Malaria Action Program for States (MAPS) project. Authors include Abiodun Ojo, Bolatito Aiyenigba, Sonny Johnbull, Adamu Onu, Olabanji Ipadeola, Muhammad Salihu, Kolawole Maxwell, Ebenezer Baba, and Abba Umar. Their presentation appeared at the recent annual meeting of the American Society of Tropical Medicine and Hygiene.

The private sector’s role in health services in Nigeria has increased in recent times, and provides approximately 60% of health services. The PMI Malaria Action Program for States (MAPS) project currently supports the implementation of parasitological confirmation of malaria cases in public health facilities only in selected states. A mapping exercise was carried out to identify private facilities providing malaria diagnostic services and determine the gaps in existing malaria diagnostic capacity with the aim of designing a strategy for improvement

Questionnaires were administered to the private health facility owners and location data collected using handheld Global Positioning System (GPS) device. Data were collected from all private health facilities in the state capital of each MAPS supported states (Benue, Cross River, Ebonyi, Kogi, Nasarawa, Oyo and Zamfara) in October 2013.

Private sector staff distributionThe questionnaire was designed to assess human resource capacity, method of malaria diagnosis and patient/client workload in the health facility. Data collectors and supervisors were trained on tools and methodology of the survey.

Results revealed that 394 private health facilities in 7 state capitals were mapped. Only 24.6% health workers had received training on malaria diagnosis in the last 12 months preceding the survey, while 35% had no formal or on-the?job training.

Private sector malaria servicesSeventy-one health facilities had no routinely available malaria diagnostic services; 55 (77.5%) of these, referred patients to other health facilities where there is availability of malaria diagnosis, 6 (8.5%) prepared microscopy slides and sent to other laboratories for malaria examination, and 10 (14.1%) took no diagnostic action.

Using outpatient and laboratory statistics for the 3 months preceding the survey we found that the overall prevalence of clinically diagnosed malaria in the outpatient clinics was 70.3%. The malaria slide positivity rate was 78.8%. An antimalarial drug was prescribed on average 1.2 times out of every 10 negative malaria test results.

A good pool of human resources exist in private health facilities and their capacity needs to be built on malaria diagnosis especially mRDT for non laboratory staff. Quality of malaria microscopy could be improved with re?training of Laboratory Scientists.

A policy framework that provides for access to quality malaria diagnostic services and commodities while also creating an enabling environment for use of diagnostic results is needed to support the massive scale up of campaigns for malaria control towards elimination

[The contents of the poster/presentation are the responsibility of the Malaria Action Program for States Nigeria and do not necessarily reflect the views of the US Government.]

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