Documentation of the monthly validation of malaria rapid diagnostic test (RDTs) results in Benin

Since January 2023, the Ministry of Health (MoH) of Benin has implemented a nationwide, decentralised monthly malaria RDT validation program at the district level. Early results indicate improved data accuracy, reduced false-positive diagnoses, and decreased antimalarial drug use—despite stable testing volumes—suggesting better alignment between reported cases and clinical reality. The Centre de Recherche Entomologique de Cotonou (CREC) was engaged by PMI Insights to document and share the MoH’s procedures, experiences, and lessons learned over the first 18 months of implementation. This included document reviews, key informant interviews, and observation of validation sessions.

The program builds on earlier efforts dating back to 2012, addressing shortcomings of previous quarterly validation strategies—such as delays and poor adherence to RDT results—by introducing monthly district-level sessions involving both public and private facilities. A successful pilot in 2018–2019 showed significant improvements in data consistency and health worker motivation. The validation sessions are chaired by district statisticians and involve peer data checks using primary tools like registers and used RDT cassettes. Funded by PMI, the program runs on a monthly national budget of approximately 21.4 million FCFA. Despite strong structure and stakeholder engagement, key challenges remain, including administrative delays, limited private sector participation, and a need for digital tools to enhance efficiency. Sustainability concerns highlight the need to explore more targeted and government-led funding approaches.