Table 1.

Malaria policy recommendations and the indicators used to assess implementation and adherence

Policy recommendation	Indicator
All key clinical features of severe malaria should be assessed and documented	Proportion among the children with a diagnosis of malaria with documented assessment of the following clinical features: level of consciousness (AVPU scale), deep acidotic breathing or chest in-drawing (respiratory distress), fever, ability to drink, convulsions and pallor
All suspected malaria cases without a sign of severe disease should have parasitological confirmation by diagnostic testing before initiating treatment	Proportion of patients with a diagnosis of malaria with a malaria test ordered on the admission date and with the results recorded in the medical notes or laboratory register
Malaria positive cases should be prescribed anti-malarial drug	Proportion with malaria positive test prescribed anti-malarials Proportion with malaria negative test prescribed anti-malarials Type of anti-malarial drugs prescribed
Anti-malarial drug dosages; Quinine loading dose of 20 mg, maintenance dose of 10 mg and artesunate at 2.4 mg per kg body weight with a 20 % margin of error	Proportion with malaria positive prescribed quinine or artesunate and proportions with correct dosing
Management of malaria negative; anti-malarial drugs should be withheld in non-severe malaria cases with a negative test; those with signs of severe malaria be started on presumptive treatment but testing should be repeated	Proportion of patients with admission diagnosis of severe malaria but a negative admission test and given anti-malarials who had repeat testing after admission