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Effective coverage and systems effectiveness for malaria case management in sub-Saharan African countries
Katya Galactionova1, Fabrizio Tediosi1, Don de Savigny1
1Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Plos One
|May 23, 2015
Summary
Malaria treatment effectiveness is significantly reduced by health system weaknesses, including poor access, provider non-compliance, and substandard medicines. Improving these factors is crucial for sustaining malaria control gains in sub-Saharan Africa.
Area of Science:
- Public Health
- Health Systems Research
- Infectious Disease Epidemiology
Background:
- Global scale-up of malaria interventions has reduced mortality and morbidity.
- Sustaining these gains hinges on effective health system performance.
- Malaria treatment offers individual and community benefits but faces challenges.
Purpose of the Study:
- To apply systems effectiveness concepts to estimate malaria case management outcomes.
- To assess the impact of health system factors on effective treatment coverage.
- To identify key areas for improving malaria control policies in sub-Saharan Africa.
Main Methods:
- Utilized systems effectiveness concepts focusing on treatment seeking, provider compliance, adherence, and medication quality.
- Compiled data from Demographic and Health Surveys and other published sources for 43 high-burden countries.
- Estimated effective coverage and analyzed variations in health system indicators across countries.
Main Results:
- Effective coverage for malaria case management in sub-Saharan Africa ranges from 8% to 72%.
- Significant losses in treatment effectiveness were observed in all assessed countries.
- Health system inefficiencies vary by country, with different factors contributing to losses.
Conclusions:
- Health system failures significantly impede effective malaria treatment coverage.
- Interventions targeting identified system weaknesses are essential for malaria control and elimination.
- Addressing poor health system performance is a priority for malaria policies in the region.
