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Table 3 Select indicators and survey questions included in the malaria elimination readiness score by domain for MERA survey

From: Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018

Categories of indicators

Questions included

Domain 1: Resource availability

Diagnostic capacity

Malaria RDTs in stocka

Able to diagnose P. vivaxb

Essential medicines

Either ACT or oral quinine in stocka

Either injectable artesunate or quinine in stocka

Primaquine in stocka

Other commodities

Thermometer availablea

Infant weighing scale availablea

Stand-on scale availablea


Copy of National Malaria Guidelines availablea

CHV testing and diagnosis

Thermometer availablec

RDT currently availablec

ACT currently availablec

No stock-outs in past 3 monthsc

Stock management system

Stock management system being useda,c

Domain 2: Case management

CHV patient population

CHV treats children ≤ 5 years with feverc

Identifying criteria for testing for malaria

HP identifies criteria for testing for malariab

CHV identifies criteria for testing for malariac

HP elicits fever complaintd

HP takes patient’s temperatured

HP performs RDT in patient with fever complaintd

Test and treating practices

RDTs performed for reported fever in absence of current feverc,d

Patients not treated without testingb

ACT given for positive RDTc

Management of uncomplicated malaria

HPs use appropriate anti-malarialsb

CHVs follow-up with patients after treatmentc

Accessing high risk populations

CHVs assess travel history and encourage pregnant women to seek carec

SBC activities

Malaria education is performed in the communitya,c

Domain 3: Data management and use

Data reporting

Case data records are maintainedc

Data are reported to HFsc

Data analysis

Standard operating procedures (SOP) available for data analysisa

Data reviewed monthlya

Data used to make decisionsa

Case location can be mapped geographicallya

Data quality

Cases classified as confirmed or clinicala

Cases can be followed across registersa

Data quality measures in placea,c

Data quality is monitoreda

Monthly summary reports are maintainedc

Epidemic response

Actions are undertaken in the event of increase in cases above expecteda,c

Domain 4: Training, supervision and technical assistance


HFs and CHVs report receiving training on various malaria activities and data managementa,b,c


HFs and CHVs report receiving supervision visit in the last 6 monthsa,c


HFs and CHVs report receiving feedback on dataa,c

Technical assistance

HFs and CHVs report receiving technical assistance from higher level if requesteda,c

HFs and CHVs report receiving guidance on malaria outbreak responsea,c

  1. aHealth Facility (HF) assessment
  2. bHealthcare Provider (HP) interview
  3. cCommunity Health Volunteer (CHV) interview
  4. dPatient observation