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Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia

Whilst some populations have recently experienced dramatic declines in malaria, the majority of those most at risk of Plasmodium falciparum malaria still lack access to effective treatment with artemisinin combination therapy (ACT) and others are already facing parasites resistant to artemisinins. I...

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Autores principales: Yeung, Shunmay, Patouillard, Edith, Allen, Henrietta, Socheat, Duong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3173399/
https://www.ncbi.nlm.nih.gov/pubmed/21851625
http://dx.doi.org/10.1186/1475-2875-10-243
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author Yeung, Shunmay
Patouillard, Edith
Allen, Henrietta
Socheat, Duong
author_facet Yeung, Shunmay
Patouillard, Edith
Allen, Henrietta
Socheat, Duong
author_sort Yeung, Shunmay
collection PubMed
description Whilst some populations have recently experienced dramatic declines in malaria, the majority of those most at risk of Plasmodium falciparum malaria still lack access to effective treatment with artemisinin combination therapy (ACT) and others are already facing parasites resistant to artemisinins. In this context, there is a crucial need to improve both access to and targeting of ACT through greater availability of good quality ACT and parasitological diagnosis. This is an issue of increasing urgency notably in the private commercial sector, which, in many countries, plays an important role in the provision of malaria treatment. The Affordable Medicines Facility for malaria (AMFm) is a recent initiative that aims to increase the provision of affordable ACT in public, private and NGO sectors through a manufacturer-level subsidy. However, to date, there is little documented experience in the programmatic implementation of subsidized ACT in the private sector. Cambodia is in the unique position of having more than 10 years of experience not only in implementing subsidized ACT, but also rapid diagnostic tests (RDT) as part of a nationwide social marketing programme. The programme includes behaviour change communication and the training of private providers as well as the sale and distribution of Malarine, the recommended ACT, and Malacheck, the RDT. This paper describes and evaluates this experience by drawing on the results of household and provider surveys conducted since the start of the programme. The available evidence suggests that providers' and consumers' awareness of Malarine increased rapidly, but that of Malacheck much less so. In addition, improvements in ACT and RDT availability and uptake were relatively slow, particularly in more remote areas. The lack of standardization in the survey methods and the gaps in the data highlight the importance of establishing a clear system for monitoring and evaluation for similar initiatives. Despite these limitations, a number of important lessons can still be learnt. These include the importance of a comprehensive communications strategy and of a sustained and reliable supply of products, with attention to the geographical reach of both. Other important challenges relate to the difficulty in incentivising providers and consumers not only to choose the recommended drug, but to precede this with a confirmatory blood test and ensure that providers adhere to the test results and patients to the treatment regime. In Cambodia, this is particularly complicated due to problems inherent to the drug itself and the emergence of artemisinin resistance.
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spelling pubmed-31733992011-09-15 Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia Yeung, Shunmay Patouillard, Edith Allen, Henrietta Socheat, Duong Malar J Case Study Whilst some populations have recently experienced dramatic declines in malaria, the majority of those most at risk of Plasmodium falciparum malaria still lack access to effective treatment with artemisinin combination therapy (ACT) and others are already facing parasites resistant to artemisinins. In this context, there is a crucial need to improve both access to and targeting of ACT through greater availability of good quality ACT and parasitological diagnosis. This is an issue of increasing urgency notably in the private commercial sector, which, in many countries, plays an important role in the provision of malaria treatment. The Affordable Medicines Facility for malaria (AMFm) is a recent initiative that aims to increase the provision of affordable ACT in public, private and NGO sectors through a manufacturer-level subsidy. However, to date, there is little documented experience in the programmatic implementation of subsidized ACT in the private sector. Cambodia is in the unique position of having more than 10 years of experience not only in implementing subsidized ACT, but also rapid diagnostic tests (RDT) as part of a nationwide social marketing programme. The programme includes behaviour change communication and the training of private providers as well as the sale and distribution of Malarine, the recommended ACT, and Malacheck, the RDT. This paper describes and evaluates this experience by drawing on the results of household and provider surveys conducted since the start of the programme. The available evidence suggests that providers' and consumers' awareness of Malarine increased rapidly, but that of Malacheck much less so. In addition, improvements in ACT and RDT availability and uptake were relatively slow, particularly in more remote areas. The lack of standardization in the survey methods and the gaps in the data highlight the importance of establishing a clear system for monitoring and evaluation for similar initiatives. Despite these limitations, a number of important lessons can still be learnt. These include the importance of a comprehensive communications strategy and of a sustained and reliable supply of products, with attention to the geographical reach of both. Other important challenges relate to the difficulty in incentivising providers and consumers not only to choose the recommended drug, but to precede this with a confirmatory blood test and ensure that providers adhere to the test results and patients to the treatment regime. In Cambodia, this is particularly complicated due to problems inherent to the drug itself and the emergence of artemisinin resistance. BioMed Central 2011-08-18 /pmc/articles/PMC3173399/ /pubmed/21851625 http://dx.doi.org/10.1186/1475-2875-10-243 Text en Copyright ©2011 Yeung et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Study
Yeung, Shunmay
Patouillard, Edith
Allen, Henrietta
Socheat, Duong
Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia
title Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia
title_full Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia
title_fullStr Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia
title_full_unstemmed Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia
title_short Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia
title_sort socially-marketed rapid diagnostic tests and act in the private sector: ten years of experience in cambodia
topic Case Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3173399/
https://www.ncbi.nlm.nih.gov/pubmed/21851625
http://dx.doi.org/10.1186/1475-2875-10-243
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