Table 1 Components and content of the intervention in the mRDT and control arms

Training of DSVs

Four-day interactive training workshops covering practical skills, knowledge and communication skills in the following topics:

Three-day interactive training workshops covering practical skills, knowledge and communication skills in the following topics:

• The new role of DSVs with ACT and mRDT

• The new role of DSVs with Coartem

• How to receive clients, confirm fever and start recording

• How to receive clients, assess fever and start recording

• Performing and reading an mRDT and blood slides

• How recognize and assess clients with signs of severe illness

• How to recognize clients with signs of severe illness

• Taking a blood slide

• How to treat clients who are mRDT-positive, including treatment of uncomplicated malaria with Coartem and treatment and referral of severe malaria including rectal artesunate suppositories

• How to treat clients with fever

• How to deal with clients who are mRDT-negative, including referral and explaining negative mRDT results

• How to check for any other signs of illness

• Keeping records, storage and monitoring mRDT and ACT

• Keeping records, storage and monitoring of Coartem

Job aids

Take-home materials: flow chart, job aid incorporating mRDTs, artesunate and referral forms; Danger r signs

Take-home training manual; flow chart job aid incorporating presumptive treatment, artesunate and referral; referral job aid for presumptive treatment; danger signs job aid for presumptive treatment

Referral forms

Supply of referral forms for sending with clients to health facilities, colour-coded for routine or emergency referral, incorporating mRDT results

Supply of referral forms for sending with clients to health facilities, colour-coded for routine or emergency referral

Certification

A4 certificate detailing completion of course in ‘ Use of Artemisinin-based combination therapies and Rapid diagnostics tests for home-based management of fever in Uganda’ with Ministry of Health logo

A4 certificate detailing completion of course in ‘ Use of Artemisinin-based combination therapies for home-based management of fever in Uganda’ with Ministry of Health logo

Supportive supervision

Initial 3-month period of intense support with regular weekly visits conducted by project staff with on-the-spot feedback on Coartem and mRDT use, record-keeping and other project- related topics

Initial 3-month period of intense support with regular weekly visits conducted by project staff with on-the-spot feedback on Coartem use, record-keeping and other project- related topics

Registers and stock cards

Supply of registers with treatment record forms for each client including mRDT recording; supply of stock cards to monitor supply of Coartem (yellow and blue), mRDTs, rectal artesunate and blood slides

Supply of registers with treatment record forms for each client; supply of stock cards to monitor supply of Coartem (yellow and blue), rectal artesunate and blood slides

Supplies

Distribution of mRDTs and Coartem by the study team either by direct delivery or visits from DSVs to the project office. Continuous supply was ensured through visits and mobile phone communication between DSVs and project staff.

Distribution of Coartem by the study team either by direct delivery or visits from DSVs to the project office. Continuous supply was ensured through visits and mobile phone communication between DSVs and project staff.

Recommended retail pricing

Pricing lists for mRDTs and Coartem provided to DSVs with Ministry of Health logo

Pricing lists for Coartem provided to DSVs with Ministry of Health logo

Advertising placard

Each DSV was given a placard to place in the roadside near their shop to advertise the availability of malaria diagnostics.

No placards were given.

Community sensitization

Meetings within 8 sub-counties (in which the 20 clusters were located) to meet political leaders and get their consent; training of sub-county trainers, identifying Village Health Teams (VHTs) who would carry out community sensitization; and to organize training of VHTs.

SOPs

Distribution and training in standard operating procedures for project activities including completion of records, making blood slides, storage of project-related materials, logistics of supplies and collections for blood slides

Supplies of project materials

Supply of materials for carrying out blood slides for the trial evaluation, including gloves, lancets, slides and storage, sharps boxes. Routine collection of blood slides and sharps boxes, ensuring supply of materials required.

Health facility

Sensitization about project

Health units in the study area were visited and made aware of the referrals from DSVs and requested to keep records on the referrals.