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APHA Scientific Session and Event Listing

Improving access to essential medicines for effective malaria case management in endemic countries

Rima Shretta, MSc, Rational Pharmaceutical Management Plus Program, Management Sciences for Health, 4301 North Fairfax Drive, Arlington, VA 22203, 703-524-6575, rshretta@msh.org

The availability, appropriate management, and rational use of antimalarial medicines are critical to achieving successful outcomes in malaria case management and preventing drug resistance. Outcomes depend on a variety of factors, including the timely decision to treat based on recognizing symptoms/signs; availability and accessibility of the right drugs of appropriate quality in the appropriate formulations and amounts; use of the drugs according to an appropriate regimen (dose, frequency, duration); and timely and appropriate follow-up or referral, particularly if treatment failure occurs.

This paper discusses the technical and operational challenges faced by Democratic Republic of Congo, Ghana, Kenya, and Mali in improving access to essential antimalarials. Challenges ranged from poor recognition of symptoms, delayed treatment-seeking behaviors, poor prescribing practices by health workers, inappropriate doses and durations of treatment, and inability to recognize signs and symptoms of severe malaria. A framework for recognizing how the various interventions can influence decision-making at each level of treatment seeking and case management is introduced. Various strategies and interventions have been used to address these challenges at the regional and country level, including training public and private providers in pharmaceutical management; introducing rapid diagnostic tests; implementing home-based management strategies; as well linking surveillance of drug use practices, drug efficacy, and drug quality. Intervention results showed an improvement in malaria case management at the country level.

To impact public health outcomes, countries need to consider the sources from which patients and caretakers access treatment, then use a multifaceted approach to implementing interventions that increase access to antimalarials.

Learning Objectives: At the conclusion of the session, participants will be able to

Keywords: Access to Health Care, Disease Management

Presenting author's disclosure statement:

Any relevant financial relationships? No

Improving Access to Essential Drugs

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA