Malaria is a preventable and curable, yet life-threatening disease caused by parasites that are transmitted to people by infected mosquitoes; its first symptom is usually fever. The World Health Organization (WHO) recommends that febrile patients be tested using microscopy or rapid diagnostic tests (RDTs) before they are treated with artemisinin-based combination therapy (ACT), the topline malaria treatment.
In many endemic countries, a large proportion of people first go to a private health provider when they have a fever. Because RDTs are either non-existent or more expensive than ACT in the private health sector, clients with fevers are often presumptively treated with ACT. This practice leads to mistreatment of other, potentially life-threatening, diseases and to the overuse of ACT.
In a recent Newsweek article, Amy Maxmen highlighted PSI’s efforts to create a private-sector market for rapid diagnostic tests to diagnose fever in Tanzania. Read the article here.
The project highlighted in the article is being funded by the financing mechanism UNITAID. PSI is the lead implementer, in partnership with Foundation for Innovative New Diagnostics (FIND), Malaria Consortium (MC) and the World Health Organization (WHO).
Currently underway in Kenya, Madagascar, Nigeria, Tanzania and Uganda, it creates a private sector market for malaria RDTs, by (i) increasing both access to and demand for quality-assured RDTs, (ii) improving private providers’ fever case management skills and (iii) developing and implementing a roadmap for public-private engagement that will guide policy and regulation.
PSI is implementing this project in Kenya, Madagascar and Tanzania and is doing the following:
- Increasing access to RDTs: PSI makes sure the supply chain functions reliably to deliver quality RDTs at the lowest possible price with the lowest possible margins.
- Increasing demand for RDTs – from both the provider and the consumer:
- ‘It’s good for me’: PSI informs consumers about the importance of being correctly diagnosed before being given a drug through behaviour change communications activities, such as road shows, radio advertisements and point of sales advertising. PSI also carries out research to better understand how consumers seek treatment for fever, and how they are managed by private sector providers.
- ‘It’s good for business’: By using RDTs and adhering to WHO guidelines, providers improve their case management skills and increase their credibility in the community, which results in more customers.
- Ensuring quality of service: By training providers and carrying out supportive supervision, PSI helps them improve their case management skills – e. only giving an ACT when the patient has malaria. This is done using innovative monitoring techniques, as well as carrying out mystery client interviews.
Finally, PSI and its partners are working with Ministries of Health to develop and disseminate a roadmap to assure that affordable, quality-assured RDTs continue to be made available in the private sector by leveraging the systems, learning and evidence generated by the project.
For more information on this project, please contact Nikki Charman, Project Director. [email protected]
Photo credit: Jake Lyell
