Improving drug availability and financial accessibility to health services have been identified as the two main priorities for health policy action. Policy-makers should respect these patient preferences to deliver effective improvement of the quality of care as a potential means to increase utilization of health care.

The rapid and correct diagnosis of fever and anaemia at the household level is a prerequisite for the successful management and control of life-threatening disease among young children, particularly in malaria-endemic areas of Africa. The ability of mothers to diagnose fever and anaemia in their young children has recently been explored, as part of a large, birth-cohort study in rural, north-western Burkina Faso. During a cross-sectional survey in six villages, 345 children aged, <3 years and their mothers were investigated. Each mother was asked if she considered her child to be febrile and/or anaemic before that child's temperature and haematocrit were measured, with an electronic thermometer and portable centrifuge, respectively. The recorded prevalences of fever (> or =37.5 degrees C) and anaemia (haematocrit, <25%) in the children were 12.2% and 21.4%, respectively. The mothers' diagnoses had a sensitivity of 76.2% [95% confidence interval (CI)=60.6%-88.0%] for fever and 4.1% (CI=0.8%-11.4%) for anaemia, with corresponding specificities of 87.1% (CI=82.8%-90.7%) and 95.9% (CI=92.9%-98.0%). Mothers in rural Africa appear to be fairly accurate in detecting fever in their children but less accurate in detecting anaemia. While malaria control needs to employ a mix of preventive and curative measures, anaemia control will benefit from community-based malaria-control measures as well as broader approaches addressing the nutritional status of young children.