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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

Line chart showing the proportion of confirmed malaria cases treated by region, 2012–2015
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Fig4: Line chart showing the proportion of confirmed malaria cases treated by region, 2012–2015

Mentions: The malaria microscopy slide positivity rate was 24.5 % (198,066/807,275). Almost half of confirmed cases (50.4 %) were P. falciparum, 45.6 % were P. vivax (and the rest (4.1 %) were mixed species P. falciparum/P. vivax infections (Table 3). The malaria RDT positivity rate was 36.2 %. The Plasmodium species identified using RDT: 55.0 % were P. falciparum, 40.2 % were P. vivax, and 4.7 % were mixed infections (Table 4). The overall malaria parasite detection rate (either using microscopy or RDT) was 25.1 % (214,259/851,994). And the proportion of Plasmodium species confirmed in PPP facilities consists of 50.7 % were P. falciparum, 45.2 % were P. vivax and 4.1 % were mixed infections (Table 3). Making malaria diagnosis according to the national standards with parasitological confirmation was significantly improved from 87.7 % during the first 3 months to almost 100.0 % in the last 3 months, and PPP for malaria care facilities showed up their commitment with sustaining the results (Fig. 4).Table 3


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)

Line chart showing the proportion of confirmed malaria cases treated by region, 2012–2015
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: Line chart showing the proportion of confirmed malaria cases treated by region, 2012–2015
Mentions: The malaria microscopy slide positivity rate was 24.5 % (198,066/807,275). Almost half of confirmed cases (50.4 %) were P. falciparum, 45.6 % were P. vivax (and the rest (4.1 %) were mixed species P. falciparum/P. vivax infections (Table 3). The malaria RDT positivity rate was 36.2 %. The Plasmodium species identified using RDT: 55.0 % were P. falciparum, 40.2 % were P. vivax, and 4.7 % were mixed infections (Table 4). The overall malaria parasite detection rate (either using microscopy or RDT) was 25.1 % (214,259/851,994). And the proportion of Plasmodium species confirmed in PPP facilities consists of 50.7 % were P. falciparum, 45.2 % were P. vivax and 4.1 % were mixed infections (Table 3). Making malaria diagnosis according to the national standards with parasitological confirmation was significantly improved from 87.7 % during the first 3 months to almost 100.0 % in the last 3 months, and PPP for malaria care facilities showed up their commitment with sustaining the results (Fig. 4).Table 3

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