Evaluation of the malaria case management in Gokwe South, a pre-elimination district in Midlands Province, Zimbabwe, 2023: A descriptive cross-sectional study

Introduction: In Zimbabwe, malaria continues to be a major public health problem. Gokwe South, a malaria pre-elimination district, failed to meet targets in malaria case management indicators, case investigation (44%), cases with microscopy (34%), and cases given primaquine (51%). We evaluated the performance of malaria case management in Gokwe South district in 2023. Method: A process outcome evaluation using the logical framework approach was used. Data were collected among healthcare workers using an interviewer-administered questionnaire, key informant guide, and checklists. The data were analyzed using Epi info 7.2.5 to generate medians, frequencies, and proportions. Results: A total of 96 healthcare workers were interviewed. Among healthcare workers trained in malaria case management 69 (71.9%), 50 (72.4%) were trained more than 12 months ago. A total of 15/20 and 8/20 health facilities had more than 6 months of stock for ACTs and IV artesunate respectively. A total of 5/20 health facilities had adequate nurses as per facility establishment. Staff from 13/20 health facilities, received one out of four malaria support and supervision visits. Inadequate healthcare worker training and unavailability of drugs and commodities were the major reasons for the failure to meet targets in malaria case management. Conclusion: The malaria control program focusing on case management in the Gokwe south district is affected by inadequate nurses, healthcare worker knowledge, unavailability of drugs and commodities, and few support and supervision visits. As a result of this study, malaria case management training was done in 2023. Funds for malaria support and supervision for all districts were availed for the first quarter of 2024.