Improving Quantification of Parasitaemia on Confirmed Malaria Blood Smears at Matungu Sub County in Kakamega County
The USAID Applying Science to Strengthen and Improve Systems project (ASSIST) has been supporting quality improvement (QI) with a focus on improving malaria case management in Kakamega County since June 2014. In February 2016, Matungu Sub County Hospital (MSCH) formed a work improvement team with the goal of improving malaria testing of suspected malaria cases through quality improvement. Rapid improvement was achieved with this initial work that they began looking for new areas to work on. In August 2016, laboratory personnel were trained in expert microscopic examination of blood slides for malaria parasites. MSCH laboratory team was required to report blood slides of confirmed cases in terms of the number of parasites observed. Two months passed by without the team having begun quantifying malaria parasites on confirmed blood smears. The coach working with the ASSIST’s Project Officer picked this as an improvement theme, and at the end of September 2016 conducted process mapping for malaria testing, and root cause analysis for failure to quantify parasitaemia. Countermeasures were identified and small tests of change initiated in October 2016 to help the team improve. In the preceding four months, quantification of malaria parasites on blood smears confirmed to have malaria increased tremendously from zero to greater than 90%, and the team has since sustained this performance.