Optimal price subsidies for appropriate malaria testing and treatment behaviour

Area of Science:

• Public Health
• Health Economics
• Infectious Disease Management

Background:

• Malaria remains a significant global health challenge, particularly in Africa, with high treatment costs limiting access to effective therapies.
• Presumptive diagnosis leads to undertreatment of malaria and overtreatment of other febrile illnesses, highlighting the need for improved diagnostic and treatment strategies.
• Artemisinin-based combination therapy (ACT) is the most effective malaria treatment, but access is often limited by price.

Purpose of the Study:

• To evaluate the impact of subsidies on malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) on diagnosis-treatment behavior in the private sector.
• To determine if a combined subsidy is more effective than a single subsidy in promoting appropriate malaria care-seeking behavior.

Main Methods:

• A mathematical model was developed to simulate the decision-making process of individuals with suspected malaria seeking care at drug shops.
• The model incorporated individual beliefs about RDT accuracy and malaria probability.
• Subsidies on RDTs and ACT were introduced to incentivize testing before treatment and ACT use only for confirmed cases.

Main Results:

• A combined subsidy on both RDTs and ACT was found to be cost-minimizing and improved diagnosis-treatment behavior.
• Subsidization alone was insufficient to change behavior in individuals with low trust in RDT accuracy or a strong belief in having malaria.

Conclusions:

• A combined subsidy on both RDTs and ACT is likely necessary to improve diagnosis-treatment behavior in the private sector for malaria.
• Targeted interventions may be needed for individuals with specific beliefs that hinder appropriate malaria care-seeking behavior.