Evidence of successful malaria case management policy implementation in Cambodia: results from national ACTwatch outlet surveys View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-04-08

AUTHORS

, Joe Novotny, Amandeep Singh, Lek Dysoley, Siv Sovannaroth, Huy Rekol

ABSTRACT

BACKGROUND: For over a decade, Cambodia has implemented a number of policies and innovative strategies to increase access to quality malaria case management services and address the drivers of multi-drug resistance. This paper utilizes outlet survey trend data collected by the ACTwatch project to demonstrate how changes in Cambodian policy and strategies have led to shifts in anti-malarial markets. METHODS: Anti-malarial ACTwatch outlet surveys were conducted in Cambodia in 2009 (June-July), 2011 (June-August) and 2013 (September-October). A census of all outlets with the potential to sell or distribute anti-malarials was conducted within a nationally representative sample of communes. Drug information, sales/distribution in the previous week, and retail price were collected for each anti-malarial in stock. Information on availability of malaria blood testing was also collected. RESULTS: A total of 7833 outlets were enumerated in 2009, 18,584 in 2011, and 16,153 in 2013. The percentage of public health facilities with at least one anti-malarial in stock on the day of the survey increased between 2009 (65.8%) and 2011 (90.0%) and remained high in 2013 (82.0%). Similar trends were found for village malaria workers (VMW). Overall, private sector availability of anti-malarials declined over time and varied by outlet type. By 2013 most anti-malarial stocking public health facilities (81.5%), VMW (95.4%), private for-profit health facilities (64.8%), and pharmacies (71.9%) had the countries first-line artemisinin-based combination therapy (ACT) treatment in stock. In 2013, 60% of anti-malarials were delivered through the private sector, 40% through the public sector, and the most common anti-malarial to be sold or distributed was the first-line ACT, comprising 62.8% of the national market share. Oral artemisinin monotherapy, which had accounted for 6% of total anti-malarial market share in 2009, was no longer reportedly sold/distributed in 2013. Malaria blood testing availability remained high over time among public facilities and VMW, with availability over 90% in 2011 and 2013. Moderate availability was observed in the private sector. CONCLUSIONS: Continued implementation of successful public and private sector strategies in support of evolving malaria drug treatment policies will be important to protect the efficacy of anti-malarial medicines and ultimately facilitate malaria elimination in Cambodia by 2025. More... »

PAGES

194

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12936-016-1200-2

DOI

http://dx.doi.org/10.1186/s12936-016-1200-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1044118049

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27059952


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79 malaria drug treatment policies
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81 malaria workers
82 management policy implementation
83 management services
84 market
85 market share
86 medicine
87 moderate availability
88 monotherapy
89 multi-drug resistance
90 national ACTwatch outlet surveys
91 national market share
92 number
93 number of policies
94 oral artemisinin monotherapy
95 outlet
96 outlet survey
97 outlet types
98 paper
99 percentage
100 pharmacy
101 policy
102 policy implementation
103 potential
104 previous week
105 prices
106 private sector
107 private sector availability
108 private sector strategies
109 profit health facilities
110 project
111 public facilities
112 public health facilities
113 public sector
114 quality malaria case management services
115 representative sample
116 resistance
117 results
118 retail price
119 sales/distribution
120 samples
121 sector
122 sector availability
123 sector strategies
124 services
125 share
126 shift
127 similar trend
128 stocks
129 strategies
130 successful malaria case management policy implementation
131 support
132 survey
133 survey trend data
134 testing
135 testing availability
136 therapy treatment
137 time
138 total
139 total anti-malarial market share
140 treatment
141 treatment policy
142 trend data
143 trends
144 types
145 village malaria workers
146 weeks
147 workers
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