Improving malaria case-management practices in the public sector

Since 2004 standard malaria treatment guidelines across Africa have universally changed to support the management of clinical malaria in formal, public health services with ACTs, representing one of the most significant policy changes in malaria. However, we have shown through facility-based studies in Kenya, Uganda, Zambia and Somalia that malaria case-management in the public sector remains characterized by a poor drug supply, inappropriate prescription practices, inadequate counselling of patients and a disregard of results of parasitological diagnosis aimed at reducing over-treatment. The MPHEG will expand its operational research into innovative ways of improving prescriber compliance to national guidelines, including the use of mobile phone text reminders, in-service training with improved job aides and drug supply monitoring. In addition, simple facility-healthworker-patient evaluation strategies will be developed for national monitoring of quality of malaria case management regionally to improve our currently inadequate "market intelligence" understanding of how new medicines are delivered and used within the public sector.