Fig. 1

Conceptual framework for investigating healthcare providers’ compliance with the test-before-treat guideline for malaria in a Ghanaian district. The four outer boxes in green—historical, health system factors, socio-economic factors, and political factors—represent the broader constructs that characterize the context of primary care delivery in the study setting. These contextual factors mediate the processes of RDT uptake for malaria management within that context, and invariably influence providers’ compliance with the test-before-treat guideline for malaria. The four inner boxes in blue indicate the key interactions that directly influence RDT implementation at primary care settings. The double-headed arrows indicate bi-directional influence among these components