From ACTwatch to Action: Working with the private sector in Lao PDR G MS E limination of M alaria through S urveillance Program (GEMS) ACTwatch Lao PDR Dissemination Meeting Vientiane | 25 October, 2016
GEMS | GMS Elimination of Malaria through Surveillance Bill & Melinda 2016 Cambodia Myanmar Gates Foundation 2019 Laos Vietnam Increased private sector malaria testing , treatment and reporting according to national policies in target areas of Cambodia, Lao PDR, Myanmar and Vietnam
1. How is GEMS supporting the Lao National Strategic Plan? 2. How is GEMS using the evidence produced by ACTwatch?
How is GEMS supporting the Lao National Strategic Plan?
1. NSP recognizes growing patients seeking care in the private sector 2. Private sector important in management & coordination (Obj. 1) 3. Private sector essential in universal case management (Obj. 2) 4. Private sector data is needed for complete national surveillance (Obj. 4)
1. GEMS provides training to private sector providers on national treatment guidelines 2. GEMS provides supervisory support and quality assurance 3. GEMS coordinates with CMPE to stock private sector outlets with quality ACTs & RDTs 4. GEMS ensures private sector outlets regularly report case data into the national database
1. Mobile migrant workers are identified as a key at risk group 2. Mobile workers need access to malaria testing and treatment
1. GEMS is mapping worksites to identify at risk workers 2. Malaria test and treat services will be established on worksites with quality assurance support 3. Data from worksites will contribute to national surveillance
1. Surveillance system must detect and immediately notify, investigate, classify and report 2. Private, village and mobile teams should all be reporting
1. GEMS will use a case surveillance app that collects data in real time 2. Data will be immediately accessible to CMPE through DHIS2, or shortly made available through other formats
How is GEMS using the evidence produced by ACTwatch?
Private sector positioning Up to 80% of of patients seek fever treatment through the private sector. What does ACTwatch tell us about…: The availability of quality ACTs and RDTs in the private sector? The private sector’s knowledge of national treatment guidelines? Supervision of the private sector? The private sector’s contribution to national surveillance data ?
Among all screened outlets in the survey Availability of any antimalarial in the private sector Private-sector 100 availability is lower 90 than public sector 80 PERCENT OF OUTLETS 70 Pharmacies had the 60 highest stock of 50 antimalarials, at 40 71% 30 20 10 0 Health Facility Pharmacy Drug Store General Itinerant Drug Total Private Retailer Vendor Sector
Among all screened outlets in the survey Availability of any antimalarial in the private sector N 100 62 Private for-profit facilities 90 338 Pharmacies 80 PERCENT OF OUTLETS 3 Drug Stores 70 31 General Retailers 60 3 Itinerant Drug Vendors 50 40 169 Total Private Sector 30 20 10 0 Health Facility Pharmacy Drug Store General Itinerant Drug Total Private Retailer Vendor Sector n =172 7,028 479, 15 6,295, 67,
Among all antimalarial stocking outlets Availability of any antimalarial in the private sector 100 90 Any Antimalarial PERCENT OF OUTLETS 80 First-Line ACT 70 Chloroquine 60 Primaquine 50 40 30 20 10 0 Health Pharmacy Drug Store General Itinerant Total Private Facility N=479 N=15 Retailer Drug Vendor Sector N=172 N=6,295 N=67 N=7,028
Among all outlets with at least one AM in stock Antimalarial market composition in 2015 N=402 35% of antimalarial market is comprised of 2009 the private sector Public Health Facility Community Health Worker Health Facility Pharmacy Drug Store General Retailer
Among all screened outlets across PPM and non-PPM programs Antimalarial Availability among PPM and non PPM outlets 100 PPM Any AM Non-PPM Any AM 90 PPM Any ACT Non-PPM Any ACT 80 PERCENT OF OUTLETS 70 60 50 40 30 20 10 0 Private Health Facility Pharmacy
Among all screened outlets across PPM and non-PPM programs Antimalarial Availability among PPM and non PPM outlets 100 PPM Any AM Non-PPM Any AM 90 PPM Any ACT Non-PPM Any ACT 80 PERCENT OF OUTLETS 70 60 50 40 30 20 10 0 Private Health Facility Pharmacy
Among all outlets with at least one AM in stock or in the past 3 months Availability of malaria blood testing: PPM and non-PPM areas 2015 100 90 PERCENT OF OUTLETS 80 70 60 50 40 30 20 10 0 Health Facility Pharmacy General Retailer Total Private Total Sector Private Sector
Among all outlets with at least one AM in stock or in the past 3 months Availability of malaria blood testing: PPM and non-PPM areas 2015 100 PPM Any Test Non-PPM Any Test 90 PPM Microscopy Non-PPM Microscopy 80 PPM RDT Non-PPM RDT PERCENT OF OUTLETS 70 60 50 40 30 20 10 0 Private for-Profit and Pharmacy
Among all outlets with at least one AM in stock or in the past 3 months Availability of malaria blood testing: PPM and non-PPM areas 2015 100 PPM Any Test Non-PPM Any Test 90 PPM Microscopy Non-PPM Microscopy 80 PPM RDT Non-PPM RDT PERCENT OF OUTLETS 70 60 50 40 30 20 10 0 Private for-Profit and Pharmacy
Among all outlets with at least one AM in stock or in the past 3 months Availability of malaria blood testing: PPM and non-PPM areas 2015 100 PPM Any Test Non-PPM Any Test 90 PPM Microscopy Non-PPM Microscopy 80 PPM RDT Non-PPM RDT PERCENT OF OUTLETS 70 60 50 40 30 20 10 0 Private for-Profit and Pharmacy
Among all outlets with at least one AM or/& malaria test in stock Providers who correctly state the first-line treatment and first-line dosing regimen for uncomplicated malaria in 2015 100 Treatment Dosing 90 80 PERCENT OF OUTLETS 70 60 50 40 30 20 10 0 Health Facility Pharmacy General Retailer Total Private Sector
Among all outlets with at least one AM in stock or in the past 3 months PPM and non-PPM Private Sector Engagement, 2015 100 Private for-Profit and Pharmacy 90 PERCENT OF OUTLETS 80 70 60 50 40 30 20 10 0 PPM Non-PPM PPM Non-PPM PPM Non-PPM PPM Non-PPM Training on Malaria Training on Treatment Keep records on number of Report numbers of patients Diagnosis Guidelines patients tested/treated for tested/treated for malaria to malaria government or non- governmental organization
Key Strategies Key insights to build on 1 PPM outlets perform better than non-PPM outlets 2 Mixed quality and availability of anti-malarial drugs 3 Limited availability of malaria blood testing in pharmacies 4 Limited knowledge of national guidelines 5 Limited private sector reporting into national surveillance system
Thank you
Recommend
More recommend
