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Communicating the AMFm message: exploring the effect of communication and training interventions on private for-profit provider awareness and knowledge related to a multi-country anti-malarial subsidy intervention.

Willey BA, Tougher S, Ye Y, ACTwatchGroupMann AG, Thomson R, Kourgueni IA, Amuasi JH, Ren R, Wamukoya M, Rueda ST, Taylor M, Seydou M, Nguah SB, Ndiaye S, Mberu B, Malam O, Kalolella A, Juma E, Johanes B, Festo C, Diap G, Diallo D, Bruxvoort K, Ansong D, Amin A, Adegoke CA, Hanson K, Arnold F, Goodman C - Malar. J. (2014)

Bottom Line: Based on data from over 19,500 outlets, results show that in four of eight settings, where communication campaigns were implemented for 5-9 months, 76%-94% awareness of the AMFm 'green leaf' logo, 57%-74% awareness of the ACT subsidy programme, and 52%-80% awareness of the correct recommended retail price (RRP) of subsidized ACT were recorded.The results support the interpretation that, in addition to the availability of subsidized ACT, the intensity of communication campaigns may have contributed to the reported levels of AMFm-related awareness and knowledge among private for-profit providers.Future subsidy programmes for anti-malarials or other treatments should similarly include communication activities.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. barbara.willey@lshtm.ac.uk.

ABSTRACT

Background: The Affordable Medicines Facility - malaria (AMFm), implemented at national scale in eight African countries or territories, subsidized quality-assured artemisinin combination therapy (ACT) and included communication campaigns to support implementation and promote appropriate anti-malarial use. This paper reports private for-profit provider awareness of key features of the AMFm programme, and changes in provider knowledge of appropriate malaria treatment.

Methods: This study had a non-experimental design based on nationally representative surveys of outlets stocking anti-malarials before (2009/10) and after (2011) the AMFm roll-out.

Results: Based on data from over 19,500 outlets, results show that in four of eight settings, where communication campaigns were implemented for 5-9 months, 76%-94% awareness of the AMFm 'green leaf' logo, 57%-74% awareness of the ACT subsidy programme, and 52%-80% awareness of the correct recommended retail price (RRP) of subsidized ACT were recorded. However, in the remaining four settings where communication campaigns were implemented for three months or less, levels were substantially lower. In six of eight settings, increases of at least 10 percentage points in private for-profit providers' knowledge of the correct first-line treatment for uncomplicated malaria were seen; and in three of these the levels of knowledge achieved at endline were over 80%.

Conclusions: The results support the interpretation that, in addition to the availability of subsidized ACT, the intensity of communication campaigns may have contributed to the reported levels of AMFm-related awareness and knowledge among private for-profit providers. Future subsidy programmes for anti-malarials or other treatments should similarly include communication activities.

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Related in: MedlinePlus

Awareness of the AMFm ‘green leaf’ logo *the ACT subsidy programme, and the correct recommended retail price for co-paid ACT at endline (2011) among respondents from private for-profit outlets with anti-malarials in stock on the day of the survey. *All respondents were shown a visual aid depicting the AMFm logo and were asked whether they have seen the symbol before. Providers are “able to recognise the AMFm logo” if they answer that they have seen the symbol before. Whiskers show 95% confidence intervals. No confidence intervals are shown for Zanzibar as a full census was carried out. Results for Madagascar are not presented as no recommended retail price was set for co-paid ACT in this country. Settings are roughly ordered by intensity of communication campaign and training intervention implementation (see Table 3).
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Figure 2: Awareness of the AMFm ‘green leaf’ logo *the ACT subsidy programme, and the correct recommended retail price for co-paid ACT at endline (2011) among respondents from private for-profit outlets with anti-malarials in stock on the day of the survey. *All respondents were shown a visual aid depicting the AMFm logo and were asked whether they have seen the symbol before. Providers are “able to recognise the AMFm logo” if they answer that they have seen the symbol before. Whiskers show 95% confidence intervals. No confidence intervals are shown for Zanzibar as a full census was carried out. Results for Madagascar are not presented as no recommended retail price was set for co-paid ACT in this country. Settings are roughly ordered by intensity of communication campaign and training intervention implementation (see Table 3).

Mentions: In Figure 2 and Table 4, settings are roughly ordered by intensity of communication campaign and training implementation, with Ghana and Kenya considered to have had the greatest intensity, followed by Tanzania mainland, Zanzibar and Nigeria. Niger, Madagascar and Uganda were considered to have the lowest intensity of implementation.


Communicating the AMFm message: exploring the effect of communication and training interventions on private for-profit provider awareness and knowledge related to a multi-country anti-malarial subsidy intervention.

Willey BA, Tougher S, Ye Y, ACTwatchGroupMann AG, Thomson R, Kourgueni IA, Amuasi JH, Ren R, Wamukoya M, Rueda ST, Taylor M, Seydou M, Nguah SB, Ndiaye S, Mberu B, Malam O, Kalolella A, Juma E, Johanes B, Festo C, Diap G, Diallo D, Bruxvoort K, Ansong D, Amin A, Adegoke CA, Hanson K, Arnold F, Goodman C - Malar. J. (2014)

Awareness of the AMFm ‘green leaf’ logo *the ACT subsidy programme, and the correct recommended retail price for co-paid ACT at endline (2011) among respondents from private for-profit outlets with anti-malarials in stock on the day of the survey. *All respondents were shown a visual aid depicting the AMFm logo and were asked whether they have seen the symbol before. Providers are “able to recognise the AMFm logo” if they answer that they have seen the symbol before. Whiskers show 95% confidence intervals. No confidence intervals are shown for Zanzibar as a full census was carried out. Results for Madagascar are not presented as no recommended retail price was set for co-paid ACT in this country. Settings are roughly ordered by intensity of communication campaign and training intervention implementation (see Table 3).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3924415&req=5

Figure 2: Awareness of the AMFm ‘green leaf’ logo *the ACT subsidy programme, and the correct recommended retail price for co-paid ACT at endline (2011) among respondents from private for-profit outlets with anti-malarials in stock on the day of the survey. *All respondents were shown a visual aid depicting the AMFm logo and were asked whether they have seen the symbol before. Providers are “able to recognise the AMFm logo” if they answer that they have seen the symbol before. Whiskers show 95% confidence intervals. No confidence intervals are shown for Zanzibar as a full census was carried out. Results for Madagascar are not presented as no recommended retail price was set for co-paid ACT in this country. Settings are roughly ordered by intensity of communication campaign and training intervention implementation (see Table 3).
Mentions: In Figure 2 and Table 4, settings are roughly ordered by intensity of communication campaign and training implementation, with Ghana and Kenya considered to have had the greatest intensity, followed by Tanzania mainland, Zanzibar and Nigeria. Niger, Madagascar and Uganda were considered to have the lowest intensity of implementation.

Bottom Line: Based on data from over 19,500 outlets, results show that in four of eight settings, where communication campaigns were implemented for 5-9 months, 76%-94% awareness of the AMFm 'green leaf' logo, 57%-74% awareness of the ACT subsidy programme, and 52%-80% awareness of the correct recommended retail price (RRP) of subsidized ACT were recorded.The results support the interpretation that, in addition to the availability of subsidized ACT, the intensity of communication campaigns may have contributed to the reported levels of AMFm-related awareness and knowledge among private for-profit providers.Future subsidy programmes for anti-malarials or other treatments should similarly include communication activities.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. barbara.willey@lshtm.ac.uk.

ABSTRACT

Background: The Affordable Medicines Facility - malaria (AMFm), implemented at national scale in eight African countries or territories, subsidized quality-assured artemisinin combination therapy (ACT) and included communication campaigns to support implementation and promote appropriate anti-malarial use. This paper reports private for-profit provider awareness of key features of the AMFm programme, and changes in provider knowledge of appropriate malaria treatment.

Methods: This study had a non-experimental design based on nationally representative surveys of outlets stocking anti-malarials before (2009/10) and after (2011) the AMFm roll-out.

Results: Based on data from over 19,500 outlets, results show that in four of eight settings, where communication campaigns were implemented for 5-9 months, 76%-94% awareness of the AMFm 'green leaf' logo, 57%-74% awareness of the ACT subsidy programme, and 52%-80% awareness of the correct recommended retail price (RRP) of subsidized ACT were recorded. However, in the remaining four settings where communication campaigns were implemented for three months or less, levels were substantially lower. In six of eight settings, increases of at least 10 percentage points in private for-profit providers' knowledge of the correct first-line treatment for uncomplicated malaria were seen; and in three of these the levels of knowledge achieved at endline were over 80%.

Conclusions: The results support the interpretation that, in addition to the availability of subsidized ACT, the intensity of communication campaigns may have contributed to the reported levels of AMFm-related awareness and knowledge among private for-profit providers. Future subsidy programmes for anti-malarials or other treatments should similarly include communication activities.

Show MeSH
Related in: MedlinePlus