Background: Key strategies have been implemented in Cambodia to address the threat of artemisinin drug resistance and to achieve malaria elimination. These include scale-up of a Village Malaria Worker (VMW) program, and increased private sector regulation and engagement.
Methods: Nationally-representative malaria outlet surveys were conducted in 2009, 2011, 2013 and 2015. A census of public and private outlets with potential to distribute malaria testing and/or treatment was conducted among a representative sample of administrative units. An audit was completed for all antimalarials and malaria rapid diagnostic tests (RDT), and information was also gathered on malaria microscopy.
Results: Repeat outlet surveys in Cambodia demonstrate the success of public and private strategies to improve case management. VMWs are now a common service delivery point for antimalarial treatment, and the role of the informal unregulated private sector in malaria case management has declined over time. The private sector still accounts for the majority of antimalarial distribution. In 2015, nearly half of private sector outlets providing malaria testing and/or treatment reported receiving some sort of support or engagement by government or non-government organizations, such as training or access to subsidized commodities. Given the continued role of the private sector in antimalarial distribution in Cambodia, there is need to scale up private sector engagement and support to ensure quality case management. Finally, while overall public sector readiness to test and appropriately treat has remained relatively high in recent years, gaps particularly in first-line treatment availability should be addressed to ensure that all suspected cases are tested and treated according to national guidelines.