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Challenges with implementing malaria rapid diagnostic tests at primary care facilities in a Ghanaian district: a qualitative study

Overview of attention for article published in Malaria Journal, February 2016
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Title
Challenges with implementing malaria rapid diagnostic tests at primary care facilities in a Ghanaian district: a qualitative study
Published in
Malaria Journal, February 2016
DOI 10.1186/s12936-016-1174-0
Pubmed ID
Authors

Nana Yaa Boadu, John Amuasi, Daniel Ansong, Edna Einsiedel, Devidas Menon, Stephanie K. Yanow

Abstract

Rapid diagnostic Tests (RDTs) for malaria enable diagnostic testing at primary care facilities in resource-limited settings, where weak infrastructure limits the use of microscopy. In 2010, Ghana adopted a test-before-treat guideline for malaria, with RDT use promoted to facilitate diagnosis. Yet healthcare practitioners still treat febrile patients without testing, or despite negative malaria test results. Few studies have explored RDT implementation beyond the notions of provider or patient acceptability. The aim of this study was to identify the factors directly influencing malaria RDT implementation at primary care facilities in a Ghanaian district. Qualitative interviews, focus groups and direct observations were conducted with 50 providers at six purposively selected primary care facilities in the Atwima-Nwabiagya district. Data were analysed thematically. RDT implementation was hampered by: (1) healthcare delivery constraints (weak supply chain, limited quality assurance and control, inadequate guideline emphasis, staffing limitations); (2) provider perceptions (entrenched case-management paradigms, limited preparedness for change); (3) social dynamics of care delivery (expected norms of provider-patient interaction, test affordability); and (4) limited provider engagement in policy processes leading to fragmented implementation of health sector reform. Limited health system capacity, socio-economic, political, and historical factors hampered malaria RDT implementation at primary care facilities in the study district. For effective RDT implementation providers must be: (1) adequately enabled through efficient allocation and management of essential healthcare commodities; (2) appropriately empowered with the requisite knowledge and skill through ongoing, effective professional development; and (3) actively engaged in policy dialogue to demystify socio-political misconceptions that hinder health sector reform policies from improving care delivery. Clear, consistent guideline emphasis, with complementary action to address deep-rooted provider concerns will build their confidence in, and promote uptake of recommended policies, practices, and technology for diagnosing malaria.

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The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 241 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
United States 1 <1%
Switzerland 1 <1%
South Africa 1 <1%
Unknown 237 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 48 20%
Researcher 28 12%
Student > Bachelor 23 10%
Student > Postgraduate 21 9%
Student > Ph. D. Student 18 7%
Other 35 15%
Unknown 68 28%
Readers by discipline Count As %
Medicine and Dentistry 61 25%
Nursing and Health Professions 39 16%
Social Sciences 17 7%
Agricultural and Biological Sciences 14 6%
Pharmacology, Toxicology and Pharmaceutical Science 8 3%
Other 37 15%
Unknown 65 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 March 2016.
All research outputs
#16,159,916
of 24,580,204 outputs
Outputs from Malaria Journal
#4,341
of 5,786 outputs
Outputs of similar age
#172,296
of 302,860 outputs
Outputs of similar age from Malaria Journal
#122
of 176 outputs
Altmetric has tracked 24,580,204 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,786 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one is in the 20th percentile – i.e., 20% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 302,860 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 176 others from the same source and published within six weeks on either side of this one. This one is in the 24th percentile – i.e., 24% of its contemporaries scored the same or lower than it.