Description of the main trial
malaria, febrile
MALARIA, SHOP
This is a post-hoc analysis of data collected within intervention clusters during a large community-based cluster randomised trial. The main results of the trial have been reported elsewhere.In Kenya, CHWs work on a volunteer basis and there are no formal education requirements. The ability to read and write are criteria for selection by the Ministry of Health (MOH). The role of CHWs as defined by the MOH is to promote good health through providing health education, basic treatments (such as first-aid) and referrals to healthcare facilities. The CHWs report to community health extension workers who are employees of MOH and are trained community health nurses mandated to supervise the activities of CHWs in the community units (CUs). In intervention areas, existing CHWs were trained to carry out the intervention. Two hundred seventy-two CHWs participated in offering testing, a median of 18 CHWs per cluster (range: 10–24).CareStart HRP2-based malaria mRDTs were used for testing. CareStart HRP2 detects The CHWs tested febrile patients at community level and issued AL vouchers to patients with positive results. This CHW model differs from other settings implementing community case management of malaria where the CHW is permitted to both perform the mRDT and provide antimalarials directly to the client. The voucher redemption period was 3 days whereby after that, the medicine shops were not allowed to collect the voucher. Patients with positive malaria results bought AL from medicine shops by redeeming their vouchers and leaving the voucher at the shop. The study team collected the redeemed vouchers from the medicine shops on a biweekly basis and reimbursed the difference in costs.