Country | Malaria burden (2013) [223] | National or regional elimination goal | Private sector utilization | Private sector engagement strategies for malaria | |||
---|---|---|---|---|---|---|---|
Diagnosis and case management | Successes and challenges | Case reporting | Successes and challenges | ||||
Vietnam | 35,406 cases and 6 deaths | National elimination by 2015 | No malaria-specific data available; over 60% of all outpatient care provided by private sector (as high as 80% for TB care) [224,225,226] | Regulation by government | Though Vietnam has an active social franchise network, it currently does not work with the NMCP Engagement strategies have been employed in other programme areas and may serve as guide for malaria (e.g., total market approach for contraceptives, social franchising of private clinics, and TB PPPs) | None | Malaria Information System does not include private providers Experience with TB PPPs and private sector reporting of cases can be used as model |
Cambodia | 24,130 cases and 12 deaths | Asia Pacific regional elimination by 2030 | 70% of malaria patients seek care in private sector; 75% of malaria treatment received from private sector [227] | Regulation by government Provider training Social marketing Social franchising | Increased crackdown on illegal drug outlets and establishment of drug inspection police to identify private pharmacies selling AMTs Successful rollout of prepackaged, quality-assured ACT (i.e., Malarine) Use of outlet survey results to guide policy formulation and interventions Strengthened referral linkage between public and private providers through SMS system in pilot areas only Trainings for private providers and regular meetings between public and private sectors in selected provinces Private sector remains largely unregulated, particularly drug sellers and village vendors Incentives needed to ensure proper testing and treatment even as cases decline | HMIS integration | SMS system tracks private sector referrals to public facilities (in pilot areas only) |
Myanmar | 333,871 cases and 236 deaths | Asia Pacific regional elimination by 2030 | 36% of malaria patients seek care in private sector; 65% of malaria treatment received from private sector [228, 229] | Regulation by government Provider training Social marketing Social franchising | Services and commodities sold by providers from two social franchise networks are regularly monitored and improved Distribution of RDTs and provider training as part of the Myanmar Artemisinin Resistance Containment project Successful rollout of Artemisinin Monotherapy Replacement project to increase quality-assured ACTs in private sector | None | NGOs and private providers not formally integrated with HMIS, although changes are underway |
Swaziland | 669 cases and 4 deaths | National elimination by 2015 | No malaria-specific data available but private care minimal according to key informants | None | No law for government oversight of private sector exists NMCP and partners have explored and addressed barriers to proper case management of malaria in the private sector; government and private providers have established communication channels | Notifiable or reportable disease list HMIS integration Provider trainings | Reporting malaria to HMIS and IDNS mandatory for all providers In an effort to improve reporting rates, NMCP staff visit private providers and provider training on IDNS |
Mozambique | 3,924,832 cases and 2941 deaths | Southern Africa regional elimination by 2030 | No malaria-specific data available but private care minimal according to key informants; malaria testing services available in private sector but not ACT | Regulation by government | Unofficial partnerships between government and private companies (particularly extractive industry) exist | Notifiable or reportable disease list | No existing channels for routine reporting of malaria data among private providers No law for mandatory reporting in place, therefore enforcement is poor |
Zambia | 5,465,122 cases and 3548 deaths | Southern Africa regional elimination by 2030 | 7–10% of malaria patients seek care in private sector; 12–20% of malaria treatment received from private sector; [59] proportions are larger when church-run facilities, which provide 35% of all healthcare services, are considered [230, 231] | Regulation by government Accreditation of providers | Registered and licensed private drug shops allowed to stock and sell ACTs, based on positive findings of Zambia Access to ACTs Initiative | HMIS integration | Many small private clinics, health facilities, pharmacies, and shops excluded from national and district HMIS |