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Table 2 Summary of findings from country case studies

From: Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings

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

  1. ACT artemisinin-based combination therapy, AMT artemisinin monotherapy, HMIS health management information system, IDNS Infection Diseases Notification System, NGO nongovernmental organization, NMCP National Malaria Control Programme, PPP public–private partnership, RDT rapid diagnostic test, SMS short message system, TB tuberculosis