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Evidence of successful malaria case management policy implementation in Cambodia: results from national ACTwatch outlet surveys.
Malar J. 2016 Apr 08; 15:194.MJ

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.

Authors+Show Affiliations

No affiliation info availableClinton Health Access Initiative, #7B, Str. 81 and corner Str. 109, Sangkat Boeung Raing, Khan Don Penh, Phnom Penh, Cambodia.Clinton Health Access Initiative, #7B, Str. 81 and corner Str. 109, Sangkat Boeung Raing, Khan Don Penh, Phnom Penh, Cambodia.Cambodia National Centre of Entomology, Parasitological and Malaria control, House 372, St Monivong Vong, Boeung Keng Kang I, Chamcar Mon, Phnom Penh, Cambodia. School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia.Cambodia National Centre of Entomology, Parasitological and Malaria control, House 372, St Monivong Vong, Boeung Keng Kang I, Chamcar Mon, Phnom Penh, Cambodia.Cambodia National Centre of Entomology, Parasitological and Malaria control, House 372, St Monivong Vong, Boeung Keng Kang I, Chamcar Mon, Phnom Penh, Cambodia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27059952

Citation

ACTwatch Group, et al. "Evidence of Successful Malaria Case Management Policy Implementation in Cambodia: Results From National ACTwatch Outlet Surveys." Malaria Journal, vol. 15, 2016, p. 194.
ACTwatch Group, Novotny J, Singh A, et al. Evidence of successful malaria case management policy implementation in Cambodia: results from national ACTwatch outlet surveys. Malar J. 2016;15:194.
Novotny, J., Singh, A., Dysoley, L., Sovannaroth, S., & Rekol, H. (2016). Evidence of successful malaria case management policy implementation in Cambodia: results from national ACTwatch outlet surveys. Malaria Journal, 15, 194. https://doi.org/10.1186/s12936-016-1200-2
ACTwatch Group, et al. Evidence of Successful Malaria Case Management Policy Implementation in Cambodia: Results From National ACTwatch Outlet Surveys. Malar J. 2016 Apr 8;15:194. PubMed PMID: 27059952.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence of successful malaria case management policy implementation in Cambodia: results from national ACTwatch outlet surveys. AU - ,, AU - Novotny,Joe, AU - Singh,Amandeep, AU - Dysoley,Lek, AU - Sovannaroth,Siv, AU - Rekol,Huy, Y1 - 2016/04/08/ PY - 2015/11/21/received PY - 2016/03/01/accepted PY - 2016/4/10/entrez PY - 2016/4/10/pubmed PY - 2016/12/15/medline KW - Anti-malarial KW - Availability KW - Elimination KW - Market share KW - Outlet KW - Private sector KW - Public KW - Supply KW - Treatment SP - 194 EP - 194 JF - Malaria journal JO - Malar J VL - 15 N2 - 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. SN - 1475-2875 UR - https://www.unboundmedicine.com/medline/citation/27059952/Evidence_of_successful_malaria_case_management_policy_implementation_in_Cambodia:_results_from_national_ACTwatch_outlet_surveys_ L2 - https://malariajournal.biomedcentral.com/articles/10.1186/s12936-016-1200-2 DB - PRIME DP - Unbound Medicine ER -