Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia
Abstract Background Anti-malarial medicine has a central role in malaria case management in Cambodia. It is, therefore, essential to study how anti-malarial drugs are distributed and consumed. This study aims to understand the socio-cultural complexity of anti-malarial drugs provision and usage prac...
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ftdoajarticles:oai:doaj.org/article:26af006e58f04db3afcc605b2e86d4f0 2023-05-15T15:15:34+02:00 Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia Phasy Res 2017-10-01T00:00:00Z https://doi.org/10.1186/s12936-017-2082-7 https://doaj.org/article/26af006e58f04db3afcc605b2e86d4f0 EN eng BMC http://link.springer.com/article/10.1186/s12936-017-2082-7 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-017-2082-7 1475-2875 https://doaj.org/article/26af006e58f04db3afcc605b2e86d4f0 Malaria Journal, Vol 16, Iss 1, Pp 1-9 (2017) Anti-malarial drug resistance Artemisinin Combination Therapy Choice of treatments Public and private sector Cambodia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2017 ftdoajarticles https://doi.org/10.1186/s12936-017-2082-7 2022-12-31T02:02:21Z Abstract Background Anti-malarial medicine has a central role in malaria case management in Cambodia. It is, therefore, essential to study how anti-malarial drugs are distributed and consumed. This study aims to understand the socio-cultural complexity of anti-malarial drugs provision and usage practices. Methods Semi-structured interviews and observation were conducted in Cambodia at the communal, provincial, and national levels from January 2014 to January 2015. Health ministers, non-governmental officers, anti-malarial medicines distributors, village malaria volunteers and malaria patients were interviewed. Findings The findings show that artemisinin-based combination therapy (ACT) flows into unregulated outlets, and was sold without any diagnostic tests. Affordable Medicines Facility for malaria scheme (AMFm) cannot drive ineffective anti-malarial medicines out of the market because ACT is still more expensive due to price absortion by private and public providers. Malaria patients might not consume ACT because of patients’ notions of ‘Korp’, and pharmaceutical and parasitic familiarity. The findings reflect that neither public nor private institutions have the capacity and resources to control the flow of ACT from going into the unlicensed sector. They do not have the ability to ensure that ACT is consumed after a positive rapid diagnostic test. Conclusions With a weak regulation system and ailing public health infrastructure, pharmaceutical-neoliberal mechanism like AMFm is not an effective means to eradicate any forms of malaria. Therefore, horizontal programmes, such as public health infrastructure improvement, and population participation must be implemented. Ethnical responsibilities of medical practitioners must be enforced and be included into the national curriculum. The awareness of drug resistance must be implemented at all levels. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 16 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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Anti-malarial drug resistance Artemisinin Combination Therapy Choice of treatments Public and private sector Cambodia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Anti-malarial drug resistance Artemisinin Combination Therapy Choice of treatments Public and private sector Cambodia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Phasy Res Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia |
topic_facet |
Anti-malarial drug resistance Artemisinin Combination Therapy Choice of treatments Public and private sector Cambodia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Anti-malarial medicine has a central role in malaria case management in Cambodia. It is, therefore, essential to study how anti-malarial drugs are distributed and consumed. This study aims to understand the socio-cultural complexity of anti-malarial drugs provision and usage practices. Methods Semi-structured interviews and observation were conducted in Cambodia at the communal, provincial, and national levels from January 2014 to January 2015. Health ministers, non-governmental officers, anti-malarial medicines distributors, village malaria volunteers and malaria patients were interviewed. Findings The findings show that artemisinin-based combination therapy (ACT) flows into unregulated outlets, and was sold without any diagnostic tests. Affordable Medicines Facility for malaria scheme (AMFm) cannot drive ineffective anti-malarial medicines out of the market because ACT is still more expensive due to price absortion by private and public providers. Malaria patients might not consume ACT because of patients’ notions of ‘Korp’, and pharmaceutical and parasitic familiarity. The findings reflect that neither public nor private institutions have the capacity and resources to control the flow of ACT from going into the unlicensed sector. They do not have the ability to ensure that ACT is consumed after a positive rapid diagnostic test. Conclusions With a weak regulation system and ailing public health infrastructure, pharmaceutical-neoliberal mechanism like AMFm is not an effective means to eradicate any forms of malaria. Therefore, horizontal programmes, such as public health infrastructure improvement, and population participation must be implemented. Ethnical responsibilities of medical practitioners must be enforced and be included into the national curriculum. The awareness of drug resistance must be implemented at all levels. |
format |
Article in Journal/Newspaper |
author |
Phasy Res |
author_facet |
Phasy Res |
author_sort |
Phasy Res |
title |
Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia |
title_short |
Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia |
title_full |
Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia |
title_fullStr |
Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia |
title_full_unstemmed |
Social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of Cambodia |
title_sort |
social and cultural complexities of anti-malarial drug circulation: an ethnographic investigation in three rural remote communes of cambodia |
publisher |
BMC |
publishDate |
2017 |
url |
https://doi.org/10.1186/s12936-017-2082-7 https://doaj.org/article/26af006e58f04db3afcc605b2e86d4f0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 16, Iss 1, Pp 1-9 (2017) |
op_relation |
http://link.springer.com/article/10.1186/s12936-017-2082-7 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-017-2082-7 1475-2875 https://doaj.org/article/26af006e58f04db3afcc605b2e86d4f0 |
op_doi |
https://doi.org/10.1186/s12936-017-2082-7 |
container_title |
Malaria Journal |
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16 |
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1 |
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1766345932925829120 |