Reducing the malaria burden
Following World Malaria Day on 25 April, Catherine Setchell, Senior Communications Officer for King’s Global Health Partnerships, explores the role they have played in the fight against malaria in Sierra Leone.
Despite improvements in malaria care over the last decade, the burden of malaria in Sierra Leone still affects the country, with more than 2.24 million hospital visits due to malaria each year.
To help improve the quality of care for patients suffering from fever, a major symptom of malaria, King’s Global Health Partnerships recently completed a three and a half-year project, Strengthening Health Systems to Improve Fever management (SHIFT), funded by Comic Relief and GlaxoSmithKline (GSK). A report on the project has been published exploring the impact of new initiatives and services established as part of this work.
Improved access to malaria testing and treatment
Prior to the SHIFT project, patients had to go through 35 steps to access free malaria testing at Connaught Hospital. The introduction of malaria Rapid Diagnostic Testing at triage, has reduced this to three steps. Patients with suspected malaria are now routinely tested by a trained nurse, on arrival at triage, ensuring they receive timely and appropriate care.
As part of the project, Patient Advocacy and Liaison Service (PALS) has also been launched. This is the first service of its kind in a government hospital, helping patients navigate hospital services. Sierra Leone’s Ministry of Social Welfare is now implementing PALS in seven other healthcare facilities over the next year.
A patient at Connaught Hospital, Sierra Leone, said a PALS officer:
supported me to get my medical request approved and facilitated the process for me to get treatment quickly. It would have been difficult for me if you were not around to assist me, because I virtually do not have any understanding of the processes.
Faster testing and a steady supply of malaria treatment
The pilot of a new, digital laboratory system at Connaught Hospital has also been successful, helping to improve the turn-around time of diagnostic test results, reduce clerical work, and limit the risk of errors. As a result, the Ministry of Health and Sanitation is rolling this system out nationally to other laboratory facilities.
In addition, the improved stock management system introduced at the hospital pharmacy as part of the project means that patients can now access malaria treatment more easily, helped by improved reporting of usage of supplies and malaria rates within the hospital.
The SHIFT project impact report published states:
The quality of malaria care has improved considerably as a result of the SHIFT project. Nurses have a steady supply of rapid diagnostic tests to diagnose patients; doctors have the confidence to differentiate between malaria and other diseases; and patients can be more confident about the diagnosis and treatment given to them at Connaught Hospital. Diagnosis and treatment have improved.
Training and mentoring
Throughout the project, King’s Global Health Partnerships has worked closely with Sierra Leone’s Ministry of Health and Sanitation; the National Malaria Control Programme; and Connaught Hospital, Sierra Leone’s main tertiary referral hospital, to help train and mentor more than 600 junior doctors, nurses, lab technicians, pharmacists and surveillance officers at Connaught Hospital to improve fever management and malaria diagnosis and treatment.
Discussing the impact of this training, Dr Sorie Conteh, Coordinator of Malaria Care at Connaught Hospital, Sierra Leone, said:
I noticed after the training, [house officers] are more confident to say why they’ve prescribed [a particular] drug for a patient and why they make such a decision to treat for it as severe malaria or uncomplicated malaria.
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