Low use of artemisinin-based combination therapy for febrile children under five and barriers to correct fever management in Benin: a decade after WHO recommendation

Damien, Barikissou Georgia; Aguemon, Badirou; Alfa, Daleb Abdoulaye; Bocossa, D.; Ogouyèmi-Hounto, Aurore; Remoué, Franck; Hesran, J.-Y. Le

doi:10.1186/s12889-018-5077-6

Cited by 4 publications

(4 citation statements)

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“…Also, in a study in one LGA in Kaduna state (Nigeria) [ 16 ] a lower proportion (45.2%) of the under 5 years old children, who sought care for febrile illness within 48 h, received ACT. In a study in Benin [ 21 ], a much lower proportion took ACT and paracetamol while a much higher proportion took traditional medicine (herbal tea). In another study in Uganda [ 22 ], a lower proportion (26.3%) of those who took an anti-malarial drug took an ACT.…”

Section: Discussionmentioning

confidence: 99%

Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

Omale

Oka

Okeke

et al. 2021

BMC Health Serv Res

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Background A good understanding of the demand for malaria rapid diagnostic test (MRDT), malaria health care-seeking behavior, and drug use among community members is crucial to malaria control efforts. The aim of this study was to assess the demand (use and/or request) for MRDT, health care-seeking behavior, and drug use, as well as associated factors, among rural community members (both children and adults) with fever or malaria-like illness in Ebonyi state, Nigeria. Methods A cross-sectional household survey was conducted between October 1st and November 7th, 2018, in 18 rural geographical clusters. Data was collected using a structured interviewer-administered questionnaire. Descriptive analysis was done using summary statistics. Associated factors (socio-demographic, knowledge and opinion level) were assessed using bivariate and multivariate binomial logistic regressions while the overall effects of these factors were assessed using the “postestimation test” command in Stata. Results A total of 1310 children under 5 years of age and 2329 children ages 5 years and above and adults (excluding pregnant women) (3639 overall) participated in the study. Among the 1310 children under 5 years of age: 521 (39.8%) received MRDT of which the caregivers of 82 (15.7%) requested for the MRDT; 931 (71.1%) sought care with public/private sector providers (excluding traditional practitioners/drug hawkers) the same/next day; 495 (37.8%) sought care at government primary health centres, 744 (56.8%) sought care with the patent medicine vendors (PMVs); 136 (10.4%) sought care with traditional practitioners; 1020 (77.9%) took ACTs (=88.2%, 1020/1156 of those who took anti-malarial drugs). Generally, lower values were respectively recorded among the 2329 children ages 5 years and above and adults (excluding pregnant women). The most important overarching predictor of the demand for MRDT and care-seeking behaviour was the knowledge and opinion level of respondent female heads of households about malaria and malaria diagnosis. Conclusions Among the rural community members with fever or malaria-like illness in Ebonyi state, Nigeria, while majority did not receive MRDT or diagnostic testing, and sought care with the PMVs, most took anti-malaria drugs, and mostly ACTs. Interventions are needed to improve the knowledge and opinion of the female heads of households about malaria and malaria diagnosis.

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Section: Discussionmentioning

confidence: 99%

Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

Omale

Oka

Okeke

et al. 2021

BMC Health Serv Res

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“…[1][2][3][4] The coordination dilemma has significant implications on the availability of artemisininbased combination therapies (ACTs) that are used to treat malaria in several countries within sub-Saharan Africa. [5][6][7] Presently, malaria ranks as one of the primary factors for disease and death in low-income countries, 8,9 even though there have been several efforts in the recent past that aimed to cut down the growing burden of malaria disease. While several interventions have focused on preventive (such as the provision of treated mosquito nets) and various therapeutic approaches, malaria has remained one of the oldest and deadliest diseases known to humankind.…”

Section: Introductionmentioning

confidence: 99%

“…Presently, malaria ranks as one of the primary factors for disease and death in low-income countries, 8 , 9 even though there have been several efforts in the recent past that aimed to cut down the growing burden of malaria disease. While several interventions have focused on preventive (such as the provision of treated mosquito nets) and various therapeutic approaches, malaria has remained one of the oldest and deadliest diseases known to humankind.…”

Section: Introductionmentioning

confidence: 99%

A structural equation modeling of supply chain strategies for artemisinin-based combination therapies in Uganda

Nagitta

Mkansi

Nyesiga

et al. 2021

Medicine Access @ Point of Care

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Introduction: Malaria is a killer disease in the tropical environment; artemisinin-based combination therapies (ACTs) play a central role in treating malaria. Thus, the supply and presence of ACT drugs in hospitals are a key feature in the fight against malaria. Supply chain management literature has focused on the private sector, and less attention has been paid to the public sector, especially hospitals. Aim: This study uses an interdisciplinary lens in investigating how to boost the supply and distribution of ACTs to save lives in low-income countries, specifically in Uganda. Methodology: The study adopted a quantitative research design using a questionnaire as the data collection instrument. Of the 440-population size, 304 of the sample population participated in the study. The model was estimated using structural equation modeling (SEM) to establish the causal relationship among the variables. Results: From the SEM analysis, all the hypotheses were significant at p < 0.05. The availability of ACTs is strongly affected by strategic dimensions (0.612), followed by operation dimensions (0.257); strategic determinants significantly affect operational determinants by a magnitude of 0.599. The indirect influence of the strategic determinants via operational determinants on the availability of ACTs is not significant. Overall, the factors explained 63.9% of the observed variance in the availability of ACTs, and the ACT availability can be predicted as follows: ACT availability = 0.612 × strategic determinants + 0.256 × operation determinants. Top management commitment and organizational responsiveness are among the items that positively affect the availability of ACTs. Conclusion: Strategically, hospital management should invest in cheap technology and software to minimize the unavailability of medicines. Our research suggests that strategic and operational determinants should be integrated into the hospitals’ core business and implemented by the top management. The article contributes to theoretical and policy direction in the public sector medicine supply chain, specifically in public hospitals.

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“…However, achieving quality care presents a significant challenge, especially in low-income countries (Khuluza and Heide, 2017). Malaria has remained one of the oldest and deadliest diseases of humankind (Shretta, et al, 2017), especially among children under five and expectant mothers (Damien, et al, 2018). Currently, international efforts focus on malaria eradication by rolling out new technologies, and through substantial growth in the political and financial commitment by countries, regions, and their global partners by 2050 (Feachem, et al, 2019), especially in Africa (Alonso, 2016).…”

Section: Introductionmentioning

confidence: 99%

Deconstruction of a Multi‑Embedded Supply Chain Coordination Problem Using Mixed Methods

Nagitta¹,

Mkansi²

2020

EJBRM

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It is without doubt that there are many overviews of mixed methods research in supply chain management. However, there is relatively little research and representation on the application of robust methodological approaches and techniques that take into account the dynamic nature of a multi‑embedded and specialised medicine supply chain coordination (SCC) problem. In Uganda, the distribution of artemisinin‑based combination therapies (ACTs) involves a multi‑embedded supply chain that runs across the macro, market, and micro levels of stakeholders. The multi‑embedded levels have created a coordination challenge tied to stock‑outs and unavailability of ACTs to the detriment of the patients. This study aimed to: 1) demonstrate how a mixed methods approach facilitated a better understanding of a multi‑embedded and specialised supply chain coordination problem, and 2) reveal the major factors for coordinating a multi‑embedded supply chain that can improve the availability of ACTs in the general hospitals of Uganda. An exploratory sequential mixed method approach was employed to disentangle the problem. In the first phase, focus group discussions were predominantly used to collect qualitative data, the findings of which acted as the foundation for the quantitative survey questionnaire. A Confirmatory Factor Analysis was used to determine and validate the market and macro supply chain dimensions that emerged from the survey results. The results showed that the most influential supply chain market environment dimensions that affect the availability of ACTs include information sharing with external stakeholders and supply chain interdependence. The results from the macro‑environment showed that the socio‑cultural, economic, technological, and legal dimensions influence the availability of ACTs. The contribution of this paper advances the use of mixed methods in deconstructing a complex embedded supply chain problem with implications for supply chain academics and practitioners and government bodies.

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Low use of artemisinin-based combination therapy for febrile children under five and barriers to correct fever management in Benin: a decade after WHO recommendation

Cited by 4 publications

References 46 publications

Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

Demand for malaria rapid diagnostic test, health care-seeking behaviour, and drug use among rural community members with fever or malaria-like illness in Ebonyi state, Nigeria: a cross-sectional household survey

A structural equation modeling of supply chain strategies for artemisinin-based combination therapies in Uganda

Deconstruction of a Multi‑Embedded Supply Chain Coordination Problem Using Mixed Methods

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