External Competency Assessment of Malaria Microscopists in Bhutan


Bhutan for the first time conducts External Competency Assessment of Malaria Microscopists at the Feild training centre in Punakha District Hospital from 17- 21 April 2017. Twelve senior malaria technicians are selected from the country. During the five-day assessment, the WHO Expert will grade the technicians to the different levels (viz., 1, 2, 3 & 4 based on their performance).

Prior to this External Competency Assessment of Malaria Microscopists, the technicians were trained in the WHO External Competency Assessment course as a standard measure of performance.

The methods used will be as follows:


Competence level Parasite detection (%) Species identification (%)   Parasite count within 25% of true count (%)  
90-100 90-100 50-100
2 80-89 80-89 40-49
3 70-79 70-79 30-39
4 0-69 0-69 0-29


The key reason for improving the quality assurance of malaria microscopy is for accuracy in diagnosis. Microscope diagnosis has many advantages in malaria control and elimination strategies. It also allows the programs to understand the key challenges in microscopic diagnosis and give an opportunity to correct it where ever necessary- either in equipment and good-quality reagents. “Accessing the competence and performance of Malaria Microscopists is important and it will help Bhutan towards Malaria elimination,“ WHO Expert Mr Ken added.

Mr Tandin Wangchuk, Malaria Technician from VDCP, Gelephu finds this competency assessment challenging, particularly his skills parasite species identification and parasite count, followed by slides examination over days, but nevertheless is hopeful to be graded in Level 1.
Towards the end of the External Competency Assessment of Malaria Microscopists, the performance of the technicians will be evaluated by the WHO Expert and will be graded as per the WHO methods.

[1] WHO. Jan 2016. Malaria Microscopy Quality Assurance Manual – Ver. 2