Table 2.

Intervention content

Scenario	mRDT/malaria training	Supervision	mRDT/ACT supplies	Other intervention activities
Afgh1/a	One and a half day training, following the national training package. This covered performing mRDTs (most, but not all, practiced testing) and prescribing antimalarials	None	mRDTs supplied by study	None
Afgh1/b
Afgh1/c
Cam1/a1	One day, didactic session covered three modules: malaria diagnosis, mRDTs, and malaria treatment	Monthly	mRDTs and ACTs supplied by study	None
Cam1/b1
Cam1/a2	Same as Cam1/1, plus: Interactive two day training on adapting to change (focused on WHO malaria treatment guidelines), professionalism and effective communication	Monthly	mRDTs and ACTs supplied by study	None
Cam1/b2
Ghan1/a	Two day training about the sensitivity and specificity of mRDTs, alternative causes of febrile illness and the Ghana national guidelines (which indicated presumptive treatment for children who are <5 years old)	None, but study team were present	mRDTs supplied by study	None
Ghan1/b
Nig1/a1	Half day demonstration on how to use mRDTs, which included practising conducting one test. They also received a copy of the WHO job aid, which shows the steps in using an mRDT	None	mRDTs supplied by study	None
Nig1/b1
Nig1/a2	Same as Nig1/1, plus: Two day interactive, seminar-style training, covering how to test, appropriate treatment for positive and negative results and effective communication. Those attending were given job aids (eg, treatment algorithm)	Monthly	mRDTs supplied by study	None
Nig1/b2
Nig1/a3	Same as Nig1/2	Monthly	mRDTs supplied by study	School-based activities
Nig1/b3
Tanz1/a	Two day training (standard MoH), covering performing mRDTs (including practical) and prescribing antimalarials	Routine MoH supervision only	mRDTs supplied by MoH	None
Tanz1/b
Tanz1/c
Tanz2/a1	One day training on how to use the mRDT and read the result. Antimalarial drug use guidelines were reviewed and job aids provided	None	mRDTs supplied by study	None
Tanz2/b1
Tanz2/2	Two day, didactic, MoH training on how to use mRDTs, including practical	Six-weekly, focused on supplies and reporting	mRDTs supplied by study	None
Tanz2/3	Same as Tanz2/2, plus: Three additional 90 min interactive training workshops, with one session repeated 6–7 months later. These covered: adapting to the change in the diagnosis and management of malaria; practice with confidence when using mRDTs: tools to enable change in managing febrile illness; sustaining the change in practice. Training on communication skills was included	Six-weekly, focused on supplies and reporting	mRDTs supplied by study	SMS feedback on own mRDT uptake and adherence at 5 months Two times per day motivational SMS for 15 days
Tanz2/4	Same as Tanz2/3	Six-weekly, focused on supplies and reporting	mRDTs supplied by study	SMS feedback on own mRDT uptake and adherence at 5 months Two times per day motivational SMS for 15 days. Patient leaflets and posters
Tanz3	Six to 11 days IMCI training (depending on whether refresher training or for new health workers) which included malaria diagnosis and treatment, plus 1-week study-specific training (including good clinical practice, provision of informed consent, performance and interpretation of mRDT according to the manufacturer's instructions). One day of the IMCI training focused specifically on malaria. Training covered communication skills	None	mRDTs and ACTs supplied by MoH, with study back up in the case of stockouts	IMCI training, additional study salary for providers
Uga1	Two day training session followed a week later by on-site training in facilities. Training was interactive and included performing and reading an mRDT, management of a patient with fever and either a positive or negative mRDT as well as patient communication. All health workers were invited to attend the training	Supervision at 6 weeks and 6 months	mRDTs supplied by MoH, with study back up in the case of stockouts	Training on patient-centred services; training in-charges in health centre management
Uga2/a	Four day interactive training, covering performing and reading an mRDT, how to prescribe antimalarials, how to deal with negative cases and communication skills. Providers were also given pictorial job aids	Close supervision for first 6 months (prior to evaluation)	mRDTs and ACTs supplied by study	Community sensitisation
Uga2/b
Uga3	Four day interactive training to all drug shop vendors, which covered performing and reading mRDTs, prescribing antimalarials, how to deal with mRDT negatives and communicating and negotiating with patients	Close supervision for first 2 months (prior to evaluation)	mRDTs and ACTs supplied by study	Community sensitisation