Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits
Abstract Background Private sector availability and use of malaria rapid diagnostic tests (RDTs) lags behind the public sector in Kenya. Increasing channels through which quality malaria diagnostic services are available can improve access to testing and help meet the target of universal diagnostic...
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ftdoajarticles:oai:doaj.org/article:48749b6b709549bdbc6b1b91625a9554 2023-05-15T15:18:39+02:00 Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits Stephen Poyer Anne Musuva Nancy Njoki Robi Okara Andrea Cutherell Dana Sievers Cristina Lussiana Dorothy Memusi Rebecca Kiptui Waqo Ejersa Stephanie Dolan Nicole Charman 2018-03-01T00:00:00Z https://doi.org/10.1186/s12936-018-2267-8 https://doaj.org/article/48749b6b709549bdbc6b1b91625a9554 EN eng BMC http://link.springer.com/article/10.1186/s12936-018-2267-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2267-8 1475-2875 https://doaj.org/article/48749b6b709549bdbc6b1b91625a9554 Malaria Journal, Vol 17, Iss 1, Pp 1-17 (2018) Malaria Case management Diagnosis Rapid diagnostic test Private sector Registered pharmacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2018 ftdoajarticles https://doi.org/10.1186/s12936-018-2267-8 2022-12-31T08:29:40Z Abstract Background Private sector availability and use of malaria rapid diagnostic tests (RDTs) lags behind the public sector in Kenya. Increasing channels through which quality malaria diagnostic services are available can improve access to testing and help meet the target of universal diagnostic testing. Registered pharmacies are currently not permitted to perform blood tests, and evidence of whether malaria RDTs can be used by non-laboratory private providers in line with the national malaria control guidelines is required to inform ongoing policy discussions in Kenya. Methods Two rounds of descriptive cross-sectional exit interviews and mystery client surveys were conducted at private health facilities and registered pharmacies in 2014 and 2015, 6 and 18 months into a multi-country project to prime the private sector market for the introduction of RDTs. Data were collected on reported RDT use, medicines received and prescribed, and case management of malaria test-negative mystery clients. Analysis compared outcomes at facilities and pharmacies independently for the two survey rounds. Results Across two rounds, 534 and 633 clients (including patients) from 130 and 120 outlets were interviewed, and 214 and 250 mystery client visits were completed. Reported testing by any malaria diagnostic test was higher in private health facilities than registered pharmacies in both rounds (2014: 85.6% vs. 60.8%, p < 0.001; 2015: 85.3% vs. 56.3%, p < 0.001). In registered pharmacies, testing by RDT was 52.1% in 2014 and 56.3% in 2015. At least 75% of test-positive patients received artemisinin-based combination therapy (ACT) in both rounds, with no significant difference between outlet types in either round. Provision of any anti-malarial for test-negative patients ranged from 0 to 13.9% across outlet types and rounds. In 2015, mystery clients received the correct (negative) diagnosis and did not receive an anti-malarial in 75.5% of visits to private health facilities and in 78.4% of visits to registered pharmacies. ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 17 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Malaria Case management Diagnosis Rapid diagnostic test Private sector Registered pharmacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Case management Diagnosis Rapid diagnostic test Private sector Registered pharmacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Stephen Poyer Anne Musuva Nancy Njoki Robi Okara Andrea Cutherell Dana Sievers Cristina Lussiana Dorothy Memusi Rebecca Kiptui Waqo Ejersa Stephanie Dolan Nicole Charman Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits |
topic_facet |
Malaria Case management Diagnosis Rapid diagnostic test Private sector Registered pharmacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Private sector availability and use of malaria rapid diagnostic tests (RDTs) lags behind the public sector in Kenya. Increasing channels through which quality malaria diagnostic services are available can improve access to testing and help meet the target of universal diagnostic testing. Registered pharmacies are currently not permitted to perform blood tests, and evidence of whether malaria RDTs can be used by non-laboratory private providers in line with the national malaria control guidelines is required to inform ongoing policy discussions in Kenya. Methods Two rounds of descriptive cross-sectional exit interviews and mystery client surveys were conducted at private health facilities and registered pharmacies in 2014 and 2015, 6 and 18 months into a multi-country project to prime the private sector market for the introduction of RDTs. Data were collected on reported RDT use, medicines received and prescribed, and case management of malaria test-negative mystery clients. Analysis compared outcomes at facilities and pharmacies independently for the two survey rounds. Results Across two rounds, 534 and 633 clients (including patients) from 130 and 120 outlets were interviewed, and 214 and 250 mystery client visits were completed. Reported testing by any malaria diagnostic test was higher in private health facilities than registered pharmacies in both rounds (2014: 85.6% vs. 60.8%, p < 0.001; 2015: 85.3% vs. 56.3%, p < 0.001). In registered pharmacies, testing by RDT was 52.1% in 2014 and 56.3% in 2015. At least 75% of test-positive patients received artemisinin-based combination therapy (ACT) in both rounds, with no significant difference between outlet types in either round. Provision of any anti-malarial for test-negative patients ranged from 0 to 13.9% across outlet types and rounds. In 2015, mystery clients received the correct (negative) diagnosis and did not receive an anti-malarial in 75.5% of visits to private health facilities and in 78.4% of visits to registered pharmacies. ... |
format |
Article in Journal/Newspaper |
author |
Stephen Poyer Anne Musuva Nancy Njoki Robi Okara Andrea Cutherell Dana Sievers Cristina Lussiana Dorothy Memusi Rebecca Kiptui Waqo Ejersa Stephanie Dolan Nicole Charman |
author_facet |
Stephen Poyer Anne Musuva Nancy Njoki Robi Okara Andrea Cutherell Dana Sievers Cristina Lussiana Dorothy Memusi Rebecca Kiptui Waqo Ejersa Stephanie Dolan Nicole Charman |
author_sort |
Stephen Poyer |
title |
Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits |
title_short |
Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits |
title_full |
Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits |
title_fullStr |
Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits |
title_full_unstemmed |
Fever case management at private health facilities and private pharmacies on the Kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits |
title_sort |
fever case management at private health facilities and private pharmacies on the kenyan coast: analysis of data from two rounds of client exit interviews and mystery client visits |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s12936-018-2267-8 https://doaj.org/article/48749b6b709549bdbc6b1b91625a9554 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 17, Iss 1, Pp 1-17 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s12936-018-2267-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2267-8 1475-2875 https://doaj.org/article/48749b6b709549bdbc6b1b91625a9554 |
op_doi |
https://doi.org/10.1186/s12936-018-2267-8 |
container_title |
Malaria Journal |
container_volume |
17 |
container_issue |
1 |
_version_ |
1766348848976887808 |