Connected diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya

Abstract Background In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever healthcare providers is largely insufficient. Febrile are typically treated presumptively antimalarials and/or antibiotics. Such over-prescription can lead drug resistance involves unnecessary costs health system. International funding for malaria currently not sufficient control malaria. Transition domestic challenged by UHC efforts recent COVID-19 outbreak. Herewith we present a digital approach improve efficiencies in diagnosis treatment of endemic Kisumu, Kenya: Connected Diagnostics. The objective this study evaluate feasibility, user experience clinical performance Kisumu. Methods Our intervention was performed Oct 2017–Dec 2018 across five private Patients were enrolled on M-TIBA platform, diagnostic test results digitized, only positive digitally entitled treatment. Data socio-demographics, transactions medical outcomes analysed using standard descriptive quantitative statistics. Provider perspectives gathered 19 semi-structured interviews. Results total 11,689 febrile tested through providers. Malaria positivity ranged from 7.4 30.2% between providers, significantly more amongst poor ( p < 0.05). Prescription substantially aberrant National Guidelines, 28% (4.6–63.3% per provider) prescription branded versus generic differing facilities correlating socioeconomic status clients. Challenges encountered transitioning microscopy RDT. Conclusion We provide full proof-of-concept innovative Diagnostics use digitized diagnostics earmark entitlements correct patients. This has large cost-saving quality improvement potential.