Supportive Supervision and Behavior Change Communication in Uganda

Malaria is endemic to Uganda and accounts for between thirty and fifty percent of outpatient visits and twenty percent of deaths among hospitalized children and pregnant women. Private health facilities play an important role in malaria control and prevention in Uganda, with the majority of the population seeking care here. However, the quality of malaria care and data management in private facilities is highly variable and often suboptimal. Multiple studies document a lack of regulation of these facilities, insufficient integration with national malaria case management programs, and an inadequate training of health care providers.

Against this backdrop, the research team is piloting an approach that combines supportive supervision of healthcare workers (guiding, training, and encouraging them to focus on problem-solving to assure quality of malaria case management) with behavior change communication to patients (advocacy activities to provide information about malaria, create demand for change, and foster social mobilization). The study design assigns villages to receive the supportive supervision intervention, the behavior change communication intervention, or both. The primary outcome of interest is the proportion of suspected malaria cases tested for malaria and correctly treated with artemisinin-based combination therapies (ACTs). The study will inform the design of a future effectiveness study and the Ministry of Health in Uganda’s malaria approach. Results forthcoming.