Access to malaria care

Access to care was described over six-month intervals during the pilot using the proportion of targeted communities, and population at risk, covered by an active CHW (Table ​(Table11).

Description of quantitative metrics employed to evaluate the impact of a Community Health Worker (CHW) pilot in Guna Yala, Panama

Sensitivity: Percent of positive microscopy tests that had a corresponding positive RDT

Specificity: Percent of negative microscopy tests that had a corresponding negative RDT

Blood examination rate: Number of microscopy tests/Estimated population*100

Test positivity: Number of positive microscopy tests/ Total number of microscopy tests*100

Incidence rate: Number of positive microscopy tests/ Estimated population*1000

Testing Delay: Number of days between symptom onset and test

Treatment Delay: Number of days between test and treatment initiation

Study year (Y1-Y4)

Pre-pilot (October 2014-September 2016) and pilot (October 2016-September 2018)

Population estimates were derived from 2010 census data published by Panama’s Instituto Nacional de Estadística y Censo [21]. Active CHWs were defined as those having tested persons seeking diagnosis for malaria and or having engaged in promotion of early testing and treatment for malaria in the community in the past four months. This was evaluated based on routine surveillance data and results of structured supervision visits made by VCTs every four months.