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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

Private health sector programme implementation strategies. Figure depicting the step ladder fashion implementation strategies followed by the project which includes foundation, capacity building, service delivery, exit and continuous quality improvement cycles
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Fig2: Private health sector programme implementation strategies. Figure depicting the step ladder fashion implementation strategies followed by the project which includes foundation, capacity building, service delivery, exit and continuous quality improvement cycles

Mentions: PHSP has implemented its project using its programme implementation strategies [24] with step ladder fashion (Fig. 2). The first phase of the implementation strategy is dedicated to construct the foundation of PPP approaches. PHSP has conducted preliminary discussions with all Regional State Health Bureaus (RHBs). Then, consensus building workshops were held with delegates of public sector, private sector and other relevant stakeholders. PHSP in collaboration with RSHBs conducted facility readiness assessment from January through September 2012. Using a predetermined objective criteria like service integration, malaria case load, human resources, willingness and commitment of private health facilities owners, 110 health facilities i.e. seven Primary (Lower Clinics), 10 Hospitals, 37 Higher Clinics and 56 Medium Clinics were selected [24]. Moreover, Referral directory were developed and distributed to all actors for smooth networking. Therefore, this was the time which builds the capacity of public sector leadership and governance in owning the partnerships at regional health bureaus and its line structures.Fig. 2


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)

Private health sector programme implementation strategies. Figure depicting the step ladder fashion implementation strategies followed by the project which includes foundation, capacity building, service delivery, exit and continuous quality improvement cycles
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Private health sector programme implementation strategies. Figure depicting the step ladder fashion implementation strategies followed by the project which includes foundation, capacity building, service delivery, exit and continuous quality improvement cycles
Mentions: PHSP has implemented its project using its programme implementation strategies [24] with step ladder fashion (Fig. 2). The first phase of the implementation strategy is dedicated to construct the foundation of PPP approaches. PHSP has conducted preliminary discussions with all Regional State Health Bureaus (RHBs). Then, consensus building workshops were held with delegates of public sector, private sector and other relevant stakeholders. PHSP in collaboration with RSHBs conducted facility readiness assessment from January through September 2012. Using a predetermined objective criteria like service integration, malaria case load, human resources, willingness and commitment of private health facilities owners, 110 health facilities i.e. seven Primary (Lower Clinics), 10 Hospitals, 37 Higher Clinics and 56 Medium Clinics were selected [24]. Moreover, Referral directory were developed and distributed to all actors for smooth networking. Therefore, this was the time which builds the capacity of public sector leadership and governance in owning the partnerships at regional health bureaus and its line structures.Fig. 2

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