Table 1 Malaria policy recommendations and the indicators used to assess implementation and adherence

All key clinical features of severe malaria should be assessed and documented

Proportion among the children with a diagnosis of malaria with documented assessment of the following clinical features: level of consciousness (AVPU scale), deep acidotic breathing or chest in-drawing (respiratory distress), fever, ability to drink, convulsions and pallor

All suspected malaria cases without a sign of severe disease should have parasitological confirmation by diagnostic testing before initiating treatment

Proportion of patients with a diagnosis of malaria with a malaria test ordered on the admission date and with the results recorded in the medical notes or laboratory register

Malaria positive cases should be prescribed anti-malarial drug

Proportion with malaria positive test prescribed anti-malarials

Proportion with malaria negative test prescribed anti-malarials

Type of anti-malarial drugs prescribed

Anti-malarial drug dosages; Quinine loading dose of 20 mg, maintenance dose of 10 mg and artesunate at 2.4 mg per kg body weight with a 20 % margin of error

Proportion with malaria positive prescribed quinine or artesunate and proportions with correct dosing

Management of malaria negative; anti-malarial drugs should be withheld in non-severe malaria cases with a negative test; those with signs of severe malaria be started on presumptive treatment but testing should be repeated

Proportion of patients with admission diagnosis of severe malaria but a negative admission test and given anti-malarials who had repeat testing after admission