Assessment of health facility access to care, surveillance and response readiness and readiness score for malaria elimination in four counties, Kenya, 2023

Abstract

Objectives: To determine capacity for; surveillance and response; access to care and readiness score for malaria elimination  implementation amongst the sampled health facilities.

Design: A retrospective cross-sectional study that used routinely collected Malaria program data using a District-Level Readiness for  Elimination of Malaria Tool (DREAM-IT) tool, adopted by the Ministry of Health and modified to fit the country’s context.

Settings: Four  malaria elimination target counties in Kenya namely; Kirinyaga, Nyandarua, Laikipia and Nyeri.

Subject: Healthcare workers in twenty- four sampled health facilities offering outpatient and inpatient malaria services across all levels of care. Interventions: Implementation  of malaria elimination strategy in Kenya.

Main outcome measures: Health facility readiness and score in Access to care (Case management), Surveillance and response for malaria elimination implementation. 

Results: Most of the study health facilities were  government- owned (public) and level 2. Kirinyaga recorded the best performance in case management. Surveillance and response was  performed over 50% in Kirinyaga and Nyandarua, and was poorly performed in less than 40% in Nyeri and Laikipia.

Conclusion: In  elimination settings, a case-based surveillance system with increased sensitivity and specificity as part of broader strengthening of the  passive surveillance systems is key. High-quality and prompt case management that allows testing and treatment of all suspected and  confirmed malaria cases respectively should be put in place to reduce transmission, especially in lower-level health facilities where  majority of people seek care. More investments in health systems in readiness for malaria elimination implementation in Kenya is  required.