Malaria case-management in urban area: Various challenges in public and private health facilities in benin, West Africa

Background: In Benin, malaria remains endemic and perennial throughout the year in most areas. During the last decade, a substantial increase was noticed in the procurement of Artemisinin-based combination therapies and malaria RDT. This study aimed to evaluate the quality of uncomplicated malaria cases-management in public and private health facilities. Methods: A cross-sectional survey was carried out in public and private health facilities in the municipality of Abomey-Calavi in southern Benin from August to September 2016. The study focused on two targets: (i) patients with uncomplicated malaria who sought care in a health facility in Abomey-Calavi during the study period; and (ii) the health care providers in public and private health facilities authorized by the Ministry of Health. Results: In 27 health facilities investigated, 15 in the public sector and 12 in the private sector, a total of 313 patients and 93 health care providers were included. Forty-four percent (44%) had no education. Among the patients, 60% were identified in the public health facilities. About 87% of uncomplicated malaria patients were tested in public facilities while 63% were tested in private facilities. In the same way, 54% of patients were treated in accordance with National Malaria Control Program (NMCP) guidelines. Conclusions: The present study showed a poor performance in uncomplicated malaria case-management in private health facilities compared to public health facilities. Strategy to improve access and utilization of malaria case-management supplies needs to be reviewed in both public and private health facilities.