Malaria, a formidable global health issue, disproportionately impacts sub-Saharan Africa, including Sierra Leone, where a substantial burden persists with a significant number of reported cases annually. This global health challenge necessitates a comprehensive approach to address its impact on public health, emphasizing the crucial role of accurate and prompt diagnosis in effective case management. Laboratory technicians play a pivotal role in malaria diagnosis, conducting microscopy examinations of blood samples for the detection of malaria parasites. The competency and reliability of these technicians are paramount for appropriate treatment and surveillance, as malaria diagnosis forms the cornerstone of case management. However, studies in sub-Saharan Africa highlight the challenges associated with maintaining and enhancing the skills of laboratory technicians over time. Factors such as inadequate training, inconsistent adherence to standard operating procedures, and limited access to necessary equipment contribute to the variable and often poor quality of microscopy. The primary aim of this research is to assess the impact of supportive supervision on malaria diagnosis service delivery among laboratory technicians in Sierra Leone The study employs a quasi-experimental design to assess the impact of supportive supervision on malaria diagnosis service delivery among laboratory technicians. A pre-designed checklist of four thematic area (Lab evaluation, Proficiency testing, External Quality Assurance and Microscopy observation) was used to collect data from 22 hospitals in three rounds of supervisory visits. Laboratory Evaluation: There was a significant improvement from R1 (64%) to R2 (93%), with a slight decrease in R3 (81%). Stockouts of consumables for microscope microscopy and stockouts of malaria RDT showed moderate improvement from R1 to R3. For example, stockouts of malaria RDT improved from 35% to 59%. Scores related to microscopes, spare parts, and maintenance showed consistent improvement, particularly from R1 (29%) to R3 (47%). Both internal and external quality assurance scores showed an upward trend. Internal Quality Assurance increased from 49% in R1 to 81% in R3. There was a consistent improvement in this category, with scores rising from 50% in R1 to 90% in R3. The significant improvement across the rounds in all categories, particularly in the later rounds, suggests that supportive supervision played a crucial role. implying that continuous oversight and guidance significantly enhanced both accuracy and timeliness in malaria diagnosis. KEY WORDS: Microscope, Malaria Diagnosis, Laboratory Evaluation
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