Malaria

Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers’ poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine. [from abstract]

This report discusses the impacts of malaria on business. It reviews the academic literature on the impacts of malaria on economies and businesses, presents data from survey on the business impacts of malaria, discusses the actions the private sector can take to combat malaria, and reviews examples of business malaria programs. The final section makes some recommendations for businesses considering engagement in malaria control. [adapted from author]

This presentation was given as part of the Christian Health Association’s Conference: CHAs at a Crossroad Towards Achieving Health Millennium Development Goals. It provides an excellent overview of the challenges of Malaria and HIV/AIDS ; discusses the human resource needs in light of these challenges; and how to build and maintain capacity. [from author’s description]

The African Heads of State meeting in Abuja, Nigeria on Roll Back Malaria adopted effective treatment of malaria nearer the home as one of the strategies for malaria control in Africa. A potentially effective strategy for bringing early, appropriate and low cost treatment of malaria closer to the home is through the use of community health workers (CHWs). There is paucity of information about people’s actual preferences for CHWs and how stated preferences relates to revealed preferences for both the CHW strategy and other strategies for improving the timeliness of malaria treatment in not only Nigeria but in many malaria endemic countries.

The main aim of the study was to estimate how much clinician-time that malaria exacts on Malawi’s Ministry of Health resources. It estimates the proportion of finances that anti-malarial medications exact on the country’s health budget and determines whether the Malawi public health sector had adequate human resources to provide treatment. [adapted from author]

The involvement of district-level workers in local-level practical approaches to mainstreaming gender is central to facilitating change and informing health strategies. There are very few practical examples of mainstreaming gender in health, especially at the lower levels of the health sector. One approach is to build the capacity of staff to conduct and respond to gender analysis. [author’s description]

Abstract
This Guide is meant to assist members of Country Coordinating Mechanisms and other individuals and organizations involved in preparing proposals, or providing input into these proposals, for Round 6 of the Blobal Fund to Fight AIDS, Tuberculosis, and Malaria. The next-to-last section, which provides some models of successful human resources for health initiatives, may also be useful to individuals and organizations involved in work on human resource and health system strengthening.

Malaria over-diagnosis in Africa is widespread and costly both financially and in terms of morbidity and mortality from missed diagnoses. An understanding of the reasons behind malaria over-diagnosis is urgently needed to inform strategies for better targeting of antimalarials. [from abstract]

These guidelines are designed as a practical tool to help businesses implement effective malaria control programmes in order to protect their employees and the surrounding communities. They are also intended to make the case, from social, economic and business perspectives, for businesses to do so. The guidelines provide companies with a framework for choosing suitable malaria control interventions and give detailed information on how employers can initiate and manage these activities. [author’s description]

Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. This article explores how the Global Fund addresses the challenges of a health workforce bottleneck to the successful implementation of priority disease programmes. [abstract]

Home-based management of malaria (HMM) is promoted as a major strategy to improve prompt delivery of effective malaria treatment in Africa. The published literature was searched for studies that evaluated the health impact of community- and home-based treatment for malaria in Africa. [from abstract]

Increased interest in parasite-based malaria diagnosis has led to increased use of rapid diagnostic tests (RDTs), particularly in rural settings. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. Use of RDTs by volunteer community health workers (CHWs) is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. [adapted from introduction]

The objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. The study concludes that the use of the guideline with adequate training significantly improved correctness of malaria treatment with chloroquine at home. Adoption of this mode of intervention is recommended to improve compliance with drug use at home. The applicability for deploying artemisinin-based combination therapy at the community level needs to be investigated.

Malaria is a major cause of illness and death in Nigeria, and a significant drain on its economy and the poor. Yet most Nigerians do not obtain appropriate treatment for malaria, and depend on informal private providers for anti-malarial drugs (AMDs), largely through patent medicine vendors (PMVs). This study seeks to better understand the role played by PMVs in the provision of AMDs in Nigeria, and to explore ways to improve the regulation and delivery of AMDs. [from summary]

Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs). This research aimed at assessing the performance of the retail sector in rural Tanzania. Such information is urgently required to improve and broaden delivery channels for life-saving drugs. [from abstract]

Irrational drug use is contributed by many factors including care providers giving wrong drug information to patients. Dispensing staff in private pharmacy shops play a significant role in pharmaceutical management and provision of relevant information to clinicians and patients, enhancing the improvement of rational medicine use. This report offers an evaluation/staff assessment of pharmacist knowledge in a situation where they function as health workers in dispensing and prescribing medications. [adapted from introduction]

Training private drug retailers can improve early treatment of malaria at home. As well as giving important health benefits, improvements could support over-stretched public health resources, reduce household economic costs and potentially play a role in reducing the rate of development of drug resistance for OTC anti-malarial medications. [author’s description]

In the rural areas of sub-Saharan Africa, the majority of young children affected by malaria have no access to formal health services. Home treatment through mothers of febrile children supported by mother groups and local health workers has the potential to reduce malaria morbidity and mortality. [from author]

This article evaluates a malaria in-service training for community health nurses working at a village level. The program included a computer-based training package, the first of its kind for health professionals in Gambia. [adapted from abstract]

No satisfactory strategy for reducing high child mortality from malaria has yet been established in tropical Africa. The authors compared the effect on under-5 mortality of teaching mothers to promptly provide antimalarials to their sick children at home, with the present community health worker approach. The study concludes that a major reduction in under-5 mortality can be achieved in holoendemic malaria areas through training local mother coordinators to teach mothers to give under-5 children antimalarial drugs. [adapted from abstract]

This article discusses the cost-effectiveness of a recent programme that involved training shopkeepers and community mobilisation for treating childhood fevers in the rural Kilifi District in Kenya. The programme offered workshops for shopkeepers on appropriate treatment for malaria in young children and also ran community information activities, with impact maintained through refresher training and monitoring. [author’s description]

This manual was developed to assist district health management teams in countries where malaria is endemic to improve the quality of malaria treatment given by private clinics, pharmacies, shops and kiosks. It gives step-by-step instructions for how to implement a public health activity that will involve wholesalers in communicating malaria guidelines to retailers and private clinics. [author’s description]