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Improved malaria case management in formal private sector through public private partnership in Ethiopia: retrospective descriptive study.

Argaw MD, Woldegiorgis AG, Abate DT, Abebe ME - Malar. J. (2016)

Bottom Line: Evaluating adherences of health care providers to standards are paramount importance to determine the quality and the effectiveness of service delivery.Adherence to appropriate treatment using artemether-lumefantrine (AL) was improved from 47.8 % in the first quarter to 95.7 % in the last quarter (X(2) = 12.89, P < 0.001).Similarly, proper patient management using chloroquine (CQ) was improved from 44.1 % in the first quarter to 98.12 % in the last quarter (X(2) = 11.62, P < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Private Health Sector Project, Abt Associates Inc. In Ethiopia, P. O. Box 2372, 1250, Addis Ababa, Ethiopia. mdamte5@gmail.com.

ABSTRACT

Background: Malaria is a major public health problem and still reported among the 10 top causes of morbidity and mortality in Ethiopia. More than one-third of the people sought treatment from the private health sector. Evaluating adherences of health care providers to standards are paramount importance to determine the quality and the effectiveness of service delivery. Therefore, the aim of this study was to evaluate the contribution of public private mix (PPM) approach in improving quality of malaria case management among formal private providers.

Methods: A retrospective data analysis was conducted using 2959 facility-months data collected from 110 PPM for malaria care facilities located in Amhara, Dire Dawa, Hareri, Oromia, Southern Nation Nationalities and Peoples and Tigray regions. Data abstraction formats were used to collect and collate the data on quarterly bases. The data were manually cleaned and analysed using Microsoft Office Excel 2010. To claim statistical significance non-parametric McNemar test was done and decision accepted at P < 0.05.

Results: From April 2012-September 2015, a total of 873,707 malaria suspected patients were identified, of which one-fourth (25.6 %) were treated as malaria cases. Among malaria suspected cases the proportion of malaria investigation improved from recorded in first quarter 87.7-100.0 % in last quarter (X(2) = 66.84, P < 0.001). The majority (96.0 %) were parasitologically-confirmed cases either by using microscopy or rapid diagnostic tests. The overall slid positivity rate was 25.1 % of which half (50.7 %) were positive for Plasmodium falciparum and slightly lower than half (45.2 %) for Plasmodium vivax; the remaining 8790 (4.1 %) showed mixed infections of P. falciparum and P. vivax. Adherence to appropriate treatment using artemether-lumefantrine (AL) was improved from 47.8 % in the first quarter to 95.7 % in the last quarter (X(2) = 12.89, P < 0.001). Similarly, proper patient management using chloroquine (CQ) was improved from 44.1 % in the first quarter to 98.12 % in the last quarter (X(2) = 11.62, P < 0.001).

Conclusions: This study documented the chronological changes of adherence of health care providers with the national recommended standards to treat malaria. The PPM for malaria care services significantly improved the malaria case management practice of health care providers at the formal private health facilities. Therefore, regional health bureaus and partners shall closely work to scale up the initiated PPM for malaria care service.

No MeSH data available.


Related in: MedlinePlus

Map of location of Ethiopia in Africa and distribution of PPP for malaria care facilities. Map of study area with distribution of Public Private partnership for malaria care health facilities in Ethiopia
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Fig1: Map of location of Ethiopia in Africa and distribution of PPP for malaria care facilities. Map of study area with distribution of Public Private partnership for malaria care health facilities in Ethiopia

Mentions: PHSP provided its technical support in the implementation of PPM for human immuno-deficiency virus (HIV) acquired immune deficiency syndrome (AIDS), tuberculosis (TB), malaria, family planning (FP), sexually transmitted infections (STI) programmes for five regional states and two city administrations namely: Amhara, Oromia, Tigray, Southern Nations Nationalities and Peoples (SNNP), Hareri Regions and Dire Dawa and Addis Ababa City Administration. Moreover, PHSP built the capacity of 342 private health facilities, primarily private for profit, followed by private not for the profit (faith based organization) and the third group were work place facilities; with the goal of establishing effective public private partnership for improving access to and demand for quality public health services with affordable costs. The malaria programme was implemented in 110 private health facilities (Fig. 1) [24].Fig. 1


Improved malaria case management in formal private sector through public private partnership in Ethiopia: retrospective descriptive study.

Argaw MD, Woldegiorgis AG, Abate DT, Abebe ME - Malar. J. (2016)

Map of location of Ethiopia in Africa and distribution of PPP for malaria care facilities. Map of study area with distribution of Public Private partnership for malaria care health facilities in Ethiopia
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940756&req=5

Fig1: Map of location of Ethiopia in Africa and distribution of PPP for malaria care facilities. Map of study area with distribution of Public Private partnership for malaria care health facilities in Ethiopia
Mentions: PHSP provided its technical support in the implementation of PPM for human immuno-deficiency virus (HIV) acquired immune deficiency syndrome (AIDS), tuberculosis (TB), malaria, family planning (FP), sexually transmitted infections (STI) programmes for five regional states and two city administrations namely: Amhara, Oromia, Tigray, Southern Nations Nationalities and Peoples (SNNP), Hareri Regions and Dire Dawa and Addis Ababa City Administration. Moreover, PHSP built the capacity of 342 private health facilities, primarily private for profit, followed by private not for the profit (faith based organization) and the third group were work place facilities; with the goal of establishing effective public private partnership for improving access to and demand for quality public health services with affordable costs. The malaria programme was implemented in 110 private health facilities (Fig. 1) [24].Fig. 1

Bottom Line: Evaluating adherences of health care providers to standards are paramount importance to determine the quality and the effectiveness of service delivery.Adherence to appropriate treatment using artemether-lumefantrine (AL) was improved from 47.8 % in the first quarter to 95.7 % in the last quarter (X(2) = 12.89, P < 0.001).Similarly, proper patient management using chloroquine (CQ) was improved from 44.1 % in the first quarter to 98.12 % in the last quarter (X(2) = 11.62, P < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Private Health Sector Project, Abt Associates Inc. In Ethiopia, P. O. Box 2372, 1250, Addis Ababa, Ethiopia. mdamte5@gmail.com.

ABSTRACT

Background: Malaria is a major public health problem and still reported among the 10 top causes of morbidity and mortality in Ethiopia. More than one-third of the people sought treatment from the private health sector. Evaluating adherences of health care providers to standards are paramount importance to determine the quality and the effectiveness of service delivery. Therefore, the aim of this study was to evaluate the contribution of public private mix (PPM) approach in improving quality of malaria case management among formal private providers.

Methods: A retrospective data analysis was conducted using 2959 facility-months data collected from 110 PPM for malaria care facilities located in Amhara, Dire Dawa, Hareri, Oromia, Southern Nation Nationalities and Peoples and Tigray regions. Data abstraction formats were used to collect and collate the data on quarterly bases. The data were manually cleaned and analysed using Microsoft Office Excel 2010. To claim statistical significance non-parametric McNemar test was done and decision accepted at P < 0.05.

Results: From April 2012-September 2015, a total of 873,707 malaria suspected patients were identified, of which one-fourth (25.6 %) were treated as malaria cases. Among malaria suspected cases the proportion of malaria investigation improved from recorded in first quarter 87.7-100.0 % in last quarter (X(2) = 66.84, P < 0.001). The majority (96.0 %) were parasitologically-confirmed cases either by using microscopy or rapid diagnostic tests. The overall slid positivity rate was 25.1 % of which half (50.7 %) were positive for Plasmodium falciparum and slightly lower than half (45.2 %) for Plasmodium vivax; the remaining 8790 (4.1 %) showed mixed infections of P. falciparum and P. vivax. Adherence to appropriate treatment using artemether-lumefantrine (AL) was improved from 47.8 % in the first quarter to 95.7 % in the last quarter (X(2) = 12.89, P < 0.001). Similarly, proper patient management using chloroquine (CQ) was improved from 44.1 % in the first quarter to 98.12 % in the last quarter (X(2) = 11.62, P < 0.001).

Conclusions: This study documented the chronological changes of adherence of health care providers with the national recommended standards to treat malaria. The PPM for malaria care services significantly improved the malaria case management practice of health care providers at the formal private health facilities. Therefore, regional health bureaus and partners shall closely work to scale up the initiated PPM for malaria care service.

No MeSH data available.


Related in: MedlinePlus