Oretha Sondah, a registered nurse at Gayah Hill Community Clinic, has seen plenty of cases of suspected malaria in her small community in Bomi County of northwestern Liberia. The hills around her community used to be home to a thriving center of iron ore and diamond mining until it was destroyed by the 14-year Liberian civil war. Currently, most households served by Sondah’s clinic rely on small-scale farming, petty trading and remittances for sustenance. As a result, they reside in poor quality housing with high mosquito presence, putting them at high risk of contracting malaria.
But not all suspected cases of malaria, which usually presents with high fever, are actually malaria. A notable gap in service delivery across Liberia is the frequent presumptive treatment of malaria due to health worker attitudes and lack of skills to perform a rapid diagnostic test.
The Strategic Technical Assistance for Improved Health Systems Performance and Health Outcomes (STAIP) project, funded by the U.S. Agency for International Development and implemented by Jhpiego, seeks to address this gap. Since 2019, the STAIP project has promoted parasite-based diagnosis of malaria by building the capacity of health workers like Sondah through in-service training, supportive supervision and continual coaching and mentoring.
As a result, Sondah understands that performing a diagnostic test is an essential step in providing quality care for malaria. “Earlier today,” she explains, “we had a young boy who I suspected had malaria after speaking with his mother. I asked some probing questions about where they live, whether they use mosquito nets and the presence or absence of other signs and symptoms. After this, we were able to confirm that he had malaria by doing a rapid diagnostic test, which returned positive. This is the way to know that I am treating the right condition.” In STAIP-supported health care facilities across Liberia, health workers like Sondah are making sure that suspected cases of malaria are being treated correctly. Their efforts, along with other STAIP project interventions, are having a positive impact, contributing to a decrease in the number of cases of clinically diagnosed malaria in Liberia from more than 360,000 in 2018 to less than 70,000 in 2021.