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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Reviewing the literature on access to prompt and effective malaria treatment in Kenya: Implications for meeting the Abuja targets
Malaria Journal, Volume 8, No. 1, Article 243, Year 2009
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Description
Background. Effective case management is central to reducing malaria mortality and morbidity worldwide, but only a minority of those affected by malaria, have access to prompt effective treatment. In Kenya, the Division of Malaria Control is committed to ensuring that 80 percent of childhood fevers are treated with effective anti-malarial medicines within 24 hours of fever onset, but this target is largely unmet. This review aimed to document evidence on access to effective malaria treatment in Kenya, identify factors that influence access, and make recommendations on how to improve prompt access to effective malaria treatment. Since treatment-seeking patterns for malaria are similar in many settings in sub-Saharan Africa, the findings presented in this review have important lessons for other malaria endemic countries. Methods. Internet searches were conducted in PUBMED (MEDLINE) and HINARI databases using specific search terms and strategies. Grey literature was obtained by soliciting reports from individual researchers working in the treatment-seeking field, from websites of major organizations involved in malaria control and from international reports. Results. The review indicated that malaria treatment-seeking occurs mostly in the informal sector; that most fevers are treated, but treatment is often ineffective. Irrational drug use was identified as a problem in most studies, but determinants of this behaviour were not documented. Availability of non-recommended medicines over-the-counter and the presence of substandard anti-malarials in the market are well documented. Demand side determinants of access include perception of illness causes, severity and timing of treatment, perceptions of treatment efficacy, simplicity of regimens and ability to pay. Supply side determinants include distance to health facilities, availability of medicines, prescribing and dispensing practices and quality of medicines. Policy level factors are around the complexity and unclear messages regarding drug policy changes. Conclusion. Kenya, like many other African countries, is still far from achieving the Abuja targets. The government, with support from donors, should invest adequately in mechanisms that promote access to effective treatment. Such approaches should focus on factors influencing multiple dimensions of access and will require the cooperation of all stakeholders working in malaria control. © 2009 Chuma et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Chuma, Jane M.
Kenya, Nairobi
Wellcome Trust Research Laboratories Nairobi
Abuya, Timothy O.
Kenya, Nairobi
Wellcome Trust Research Laboratories Nairobi
Memusi, Dorothy N.
Kenya, Nairobi
Ministry of Public Health and Sanitation
Juma, Elizabeth A.
Kenya, Nairobi
Ministry of Public Health and Sanitation
Akhwale, Willis S.
Kenya, Nairobi
Ministry of Public Health and Sanitation
Ntwiga, Janet
Kenya, Nairobi
Wellcome Trust Research Laboratories Nairobi
Nyandigisi, Andrew J.
Kenya, Nairobi
Ministry of Public Health and Sanitation
Tetteh, Gladys
Kenya, Nairobi
Management Sciences for Health
Shretta, Rima
Kenya, Nairobi
Management Sciences for Health
Amin, Abdinasir A.
Kenya, Nairobi
Management Sciences for Health
Statistics
Citations: 85
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.1186/1475-2875-8-243
e-ISSN:
14752875
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Locations
Kenya