edoc

Effective coverage and systems effectiveness for malaria case management in sub-saharan african countries

Galactionova, Katya and Tediosi, Fabrizio and de Savigny, Don and Smith, Thomas and Tanner, Marcel. (2015) Effective coverage and systems effectiveness for malaria case management in sub-saharan african countries. PLoS ONE, Vol. 10, H. 5 , e0127818.

[img]
Preview
PDF - Published Version
Available under License CC BY (Attribution).

1440Kb

Official URL: http://edoc.unibas.ch/dok/A6390995

Downloads: Statistics Overview

Abstract

Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and intervening to tac them become key priority areas for malaria control and elimination policies in the region.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Health Systems and Policies (de Savigny)
UniBasel Contributors:Tediosi, Fabrizio and de Savigny, Donald and Smith, Thomas A. and Tanner, Marcel
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Public Library of Science
e-ISSN:1932-6203
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Related URLs:
Identification Number:
Last Modified:31 Aug 2018 06:38
Deposited On:03 Jul 2015 08:53

Repository Staff Only: item control page