PSI recently hosted a webinar on how to transform the market for malaria rapid diagnostic tests (mRDTs) in the private sector. Panelists from PSI and four partner organizations, including the World Health Organization (WHO), Foundation for Innovative New Diagnostics (FIND), Johns Hopkins Bloomberg School of Public Health, and Malaria Consortium, dove deep into the lessons learned from a three-year UNITAID-funded project that worked to increase access to and demand for mRDTs in the private sector of five sub-Saharan African countries.
- Private Sector Engagement is Critical to Malaria Control
One of the three pillars set forth in WHO’s Global Technical Strategy for Malaria 2016 – 2030 is to ensure universal access to malaria prevention, diagnosis and treatment. While access to malaria diagnostics has improved greatly in the public sector due to the availability and affordability of mRDTs, the same cannot be said for the private sector. Given that 40% of the population in malaria endemic countries seek care and treatment for fever – the primary symptom of malaria – in the private sector, this means there is a critical gap in access to malaria diagnosis. As a result, malaria medications continue to be overused and other potentially life-threatening illnesses are left untreated.
“Addressing the needs of the private sector is a somewhat neglected area in malaria control, but engagement with the private sector is going to be critical if we are to deliver on these ambitious targets,” noted panelist Jane Cunningham of WHO.
PSI’s Nikki Charman additionally noted, “Fever case management in the private sector is the last neglected area in malaria control and should be a critical area of investment in health delivery going forward.”
- Engagement of all stakeholders is needed to transform the market for mRDTs in the private sector
The UNITAID private sector mRDT project worked with project partners to use a , identifying which barriers prevented access to and demand for mRDTs in the private sector. The project partners then used these results to determine the most appropriate interventions. A large part of this approach includes taking a close look at all the various players involved in the supply of mRDTs, as well as the factors influencing patients and provider demand.
“In order to get this balance of supply and demand just right in any country all players must be actively engaged,” notes Cunningham. “This includes not only manufacturers but importers, distributors, wholesalers and providers.”
In addition to sufficient supply and demand, a supportive enabling environment is needed to create a sustainable mRDT market. In project countries, regulations forbid malaria testing in many private-sector channels, including pharmacies and drug shops. Engagement with the appropriate government stakeholders has enabled testing with mRDTs among all trained providers in Madagascar, and Tanzania is working towards changing the governing rules on who can provide mRDT services.
- Private providers can offer high-quality fever case management services with sufficient training and supporting tools
Given the lack of quality assurance systems for mRDTs and fever case management services in the private sector, project partners developed a comprehensive set of tools and resources for private providers to draw upon. This included job-aids, classroom and online trainings, a tablet based application for supportive supervision, trouble shooting guides, and point-of-use tools for surveillance of mRDTs. The development and use of such tools helped private providers offer high-quality fever case management services as well as the ability of supervisors to monitor the providers’ quality of care.
Charman notes that in a 2015 study in Kenya, in which volunteers known to be negative for malaria were employed to assess providers fever case management skills, it was found that project supported pharmacies and drug shops performed similarly to private health providers in respect to diagnosis and treatment.
Want to get more in-depth knowledge of the learnings from this project? Check out the full webinar or download our brief titled: “Transforming the Private Sector to Support Universal Malaria Diagnostic Coverage.”
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Banner photo: © Population Services Kenya