Review: Provider Practice and User Behavior Interventions to Improve Prompt and Effective Treatment of Malaria: Do We Know What Works?

Abstract

Abstract. Effective case management of uncomplicated malaria is a cornerstone of successful malaria control. With current calls for the global elimination of malaria, all strategies to control malaria need to reach the highest achievable level of effective implementation. A systematic literature review of all interventions to improve provider-and/or userside behavior in the prompt and appropriate treatment of uncomplicated malaria (with appropriate evaluation design and Roll Back Malaria outcome indicators) found 23 studies for review. Only 16 studies targeted providers, nine in the public sector and seven in the private sector. Just four interventions were conducted at national scale. These data suggest that very little is known about what interventions work in improving prompt and effective treatment of malaria. In the context of scaling up effective malaria control and malaria elimination plans and in increasing access to artemisinin combination therapies (ACTs), increased research in this area is crucial.

What happened to anti-malarial markets after the Affordable Medicines Facility-malaria pilot? Trends in ACT availability, price and market share from five African countries under continuation of the private sector co-payment mechanism

“…However, awareness of official guidance is unlikely sufficient to drive ACT uptake alone and strategies are needed to influence not only provider knowledge but also provider preferences [22]. There is some evidence to suggest that trainings for providers in the informal private sector may have benefits [23]. Trainings targeting private providers were reportedly implemented as part of the CPM in Kenya and Nigeria, although evidence about implementation strength and effectiveness of these trainings is not available.…”

Assessing the cost–effectiveness of prereferral rectal artesunate for treatment of severe childhood malaria

“…Yet, as Tozan and colleagues highlight, those living in rural areas are not always able to access appropriate care in time. Several reasons for treatment delay have been identified in the literature, such as distance, the perceived characteristics of the illness, negative previous experiences in health facilities, family size and the occupation, age, gender, education and wealth of the primary caregiver [15][16][17]. Prereferral rectal artesunate cannot be expected to overcome all these barriers.…”

“…Results from the model show that, at worst, under a low intervention uptake and referral compliance scenario, the intervention is estimated to avert 19 DALYs (95% CI: [16][17][18][19][20][21] with an incremental cost-effectiveness ratio (ICER) of I$1173…”

Effects of intervention measures on irrational antibiotics/antibacterial drug use in developing countries: A systematic review

“…Also the patients and communities were possibly educated on the proper use of AB and also informing them that not all disease conditions such as acute respiratory tract infections [7,27,28,89], diarrhea [29], scabies, flu [25], malaria [22], viral infections, deliveries and surgeries [90] and many others requires AB [7,22,28] and this changes a belief where many people think that any disease condition requires a pill [27]. This greatly changes the thinking, behaviors and belief among the patients, general public and the communities on the proper use of AB and hence the seeking behavior of the individuals of these medicines and hence the habit of self-medication with antimicrobial drugs especially the AB [15,37,38,41,83,85]. Also the restriction in the access of such medicines like the AB showed to offer improvement on rational AB use especially in the Asian region as opposed to African, Latin America and south-eastern Europe [3,4].…”