In Mozambique, malaria persists as a serious health concern, especially among children under 5 and pregnant women. Accurate diagnosis is critical, yet the National Malaria Control Program (NMCP) and diagnostic labs have lacked World Health Organization (WHO)-certified malaria microscopy technicians for five years.

The U.S. President’s Malaria Initiative (PMI) Malaria Capacity Strengthening (MCAPS) Program, funded by USAID, together with the NMCP and the National Institute of Health (INS, by its Portuguese acronym), organized advanced refresher training courses for malaria microscopists with high performance and/or whose certifications have expired, followed by two workshops for external competency assessment for malaria microscopists (ECAMM).

This resulted in 13 out of 24 technicians earning their WHO ECAMM certification, making them eligible to become trainers and supervisors and playing critical roles for quality assurance of malaria diagnosis in their country, including coordinating national ECAMM sessions. For the next step, 12 of the certified technicians underwent a training of trainers and supervisors course, and 10 of these successfully achieved the required competency levels.

These new trainers became involved in conducting malaria diagnostic refresher training opportunities with a total 36 technicians in Nampula, Manica, and Zambézia provinces, strengthening their malaria diagnosis skills; thus, ‘closing the loop.’ As shown in the figure, this entire process is part of MCD’s comprehensive and sustainable approach to building national capacity for improved malaria diagnostic services.

Future plans include a national strategy to further enhance diagnostic quality assurance and establish centers of excellence in key provinces. For Senior Laboratory Technician Gilberto Feliciano Miguel (photo at top right) at Matola District Hospital in Maputo, achieving ECAMM certification has been a game changer.

“ECAMM was an important and impactful experience that significantly elevated my knowledge in malaria microscopy. Prior to this training, I was only able to identify one species of Plasmodium, and, consequently, only this single species was reported in my results,” shared Gilberto. “I am now able to identify the four species without any difficulty, and the parasite density results that I issue are reliable. Through this training, I gained tools that I have been using for regular on-the-job training of my colleagues within and outside the field of malaria microscopy.”

In-country capacity for higher quality malaria diagnosis significantly improves how cases of malaria are managed and can reduce the burden of malaria in Mozambican children and families.

This story originally appeared in MCD's 2024 Annual Report.