Table 1 Definitions of fidelity, its constructs and moderating factors based on the national malaria guidelines
Terms | Definitions |
|---|---|
Fidelity | This describes how well the health care facilities followed the guidelines as intended by those who developed it. It has four constructs, three of which were applicable in this study |
Constructs of fidelity | |
Content | The essential or core components of the “test and treat” protocol: i. Parasitological diagnosis (testing) should be carried out for all suspected cases of malaria ii. Light microscopy and malaria rapid diagnostic tests are the two recommended methods for parasitological diagnosis iii. Anti-malarial treatment should only be initiated for patients whose diagnostic tests are positive |
Coverage | How many suspected malaria cases were tested before treatment at the facility, using the last ten children aged under five years |
Frequency | How often the facility performed/requested malaria diagnostic tests before treatment of children aged under five years |
Moderating factors of implementation fidelity | |
Facilitation strategies | Supportive measures made available to facilities by government and/or its partners to enhance the implementation of the guideline. These include training, provision of guidelines, supportive supervision, on-the-job mentoring, provision of diagnostic supplies, and others |
Intervention complexity | The simplicity or complexity of the guidelines as perceived by the health care providers at the facilities |
Participant responsiveness | The level of response, engagement or ownership of the guidelines by the implementers or recipients In this study, participant responsiveness was targeted at the implementers and not the patients/recipients of the “test and treat” protocol |