Despite more than 15 years of progress, malaria remains a persistent global health challenge that claims the lives of over 400,000 individuals every year, most of whom are children under five. Strengthening the health system to deliver quality healthcare is not only essential to curb the epidemic but also beneficial to efforts against other disease areas. The U.S. President’s Malaria Initiative (PMI) Impact Malaria project, led by Population Services International (PSI) worked with national malaria programs in 12 countries to fight malaria by strengthening diagnosis, treatment, and drug-based prevention for those most at risk – particulary children and pregnant women.
In a special supplement of the American Journal of Tropical Medicine and Hygiene, we distill six years of insights from PMI Impact Malaria’s four-pronged quality improvement approach to bolster malaria case management, prevention, and treatment of malaria in pregnancy. At the core of this approach is Outreach, Training, and Supportive Supervision Plus (OTSS+), aimed at improving health facility and provider skills through on-site supportive supervision, coaching, troubleshooting, and on-the-job training, action planning and follow-up.
Dive into the successes, challenges, and invaluable learnings from our efforts to implement this novel solution towards improving malaria service quality at all levels of the health system.
Explore the Special Supplement
The U.S. President’s Malaria Initiative’s Support for Improving the Quality of Malaria Case Management Services: Fifteen Years of Progress and Learning
Through PMI Impact Malaria’s quality improvement activities – culminating in their most recent OTSS+ approach – the project has helped countries make significant progress in improving the quality of malaria services. Explore the milestones, innovations, and impactful initiatives that have supported transformative change across malaria-endemic countries and the global malaria community.
Can Outreach Training and Supportive Supervision Improve Competency in Malaria Service Delivery? An Evaluation in Cameroon, Ghana, Niger, and Zambia
OTSS was initially developed to guide improvements in malaria diagnosis and has been adapted as a package of implementation strategies to support malaria case management and prevention interventions over multiple years. In an independent evaluation, PMI Impact Malaria assessed the impact of OTSS in Cameroon, Ghana, Niger, and Zambia. Dive into a comprehensive analysis of its effectiveness in enhancing competency in malaria diagnostic testing, clinical case management, and the prevention and treatment of malaria in pregnancy.
Outreach Training and Supportive Supervision for Quality Malaria Service Delivery: A Qualitative Evaluation in 11 Sub-Saharan African Countries
Through 15 years of investment in OTSS and other QI approaches, PMI has supported a continuous cycle of implementation, learning, refinement, and expansion. Explore how OTSS catalyzes improvements in the quality of malaria services, paving the way towards improved malaria prevention and treatment based on a qualitative evaluation across eleven sub-Saharan African countries.
Clinical Outreach Training and Supportive Supervision Quality-of-Care Analysis: Impact of Readiness Factors on Health Worker Competencies in Malaria Case Management in Cameroon, Mali, and Niger
Improving the quality of malaria case management in health facilities is key to improving health outcomes in patients. This three-country review in Cameroon, Mali and Niger is one of the first to assess how service readiness affects health worker competencies in managing patients with fever correctly and providing those with confirmed uncomplicated malaria cases with appropriate treatment and referral.
Use of Supervision Data to Improve Quality of Care for Malaria in Pregnancy: Experience in Six African Countries
While interventions aimed at reducing malaria in pregnancy (MiP) tend to focus on the behaviors of pregnant women, the quality of MiP prevention and treatment care depends primarily on provider knowledge and behaviors. Learn about the major drivers that affect the competency of health workers delivering prevention and treatment services for malaria-in-pregnancy. Explore how the collection, analysis, and use of data can inform programs to protect mothers and their unborn children from malaria.
How Outreach Training and Supportive Supervision (OTSS) Affect Health Facility Readiness and Health-Care Worker Competency to Prevent and Treat Malaria in Niger: A Secondary Analysis of OTSS Data
In Niger, the National Malaria Program (NMP) has built the capacity of health workers to manage uncomplicated malaria cases primarily through classroom training; however, challenges remain in bridging the gap between national malaria guidelines and clinical practice Read a detailed secondary analysis of data from OTSS implementation in two regions of Niger, revealing the impact of this approach on health facility readiness and healthcare worker competencies.
Understanding Antenatal Care Service Quality for Malaria in Pregnancy through Supportive Supervision Data in Tanzania
Malaria in pregnancy (MiP) is associated with maternal anemia, spontaneous abortion, and infant and maternal death. Uncover how the National Malaria Control Program in Tanzania utilizes supportive supervision data to gain insights from their quality improvement efforts. Learn how these initiatives have informed healthcare practices and improved outcomes for expectant mothers.
Experiences in Improving the Quality of Community-Based Fever Management from Three Malaria-Endemic African Countries
Proactively reaching community members where they reside rather than waiting for them to seek care strengthens the ability of health systems to extend coverage beyond the facility level. Compare implementation strategies for quality improvement programs in three African countries, outlining the challenges encountered and hear examples of diverse approaches used by different countries to enhance and sustain the quality of community-based health services.
Impact of the Severe Malaria “Champions Program” on the Management of Severe Malaria Cases in 12 Hospitals of the North and Far North Regions of Cameroon
To address under-performance in severe malaria management, PMI coordinated with the National Malaria Program in Cameroon to train and equip selected clinicians from district hospitals to become “Champions” mentors for other staff in their hospitals. Explore the program’s structure and its role in improving the care of patients with severe malaria, showcasing the positive outcomes of targeted interventions and collaborative approaches in healthcare.
Outreach, Training, and Supportive Supervision: A Package of Strategies That Improves the Quality of Malaria Services and Provides a Model for Monitoring and Evaluating Their Effective Implementation
In this supplement, PMI Impact Malaria partners demonstrate through an independent evaluation how the approach is adaptable to multiple settings and can enhance service quality in high burden countries. View the key lessons learned from the results presented in this special issue and future challenges for quality improvement of malaria service delivery.
PMI Impact Malaria is funded and technically assisted by the U.S. President’s Malaria Initiative (PMI) and is led by Population Services International (PSI) in partnership with Jhpiego, MCD Global Health, and the Malaria Elimination Institute (MEI) at the University of California San Francisco.
