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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Do Price Subsidies on Artemisinin Combination Therapy for Malaria Increase Household Use?: Evidence from a Repeated Cross-Sectional Study in Remote Regions of Tanzania
PLoS ONE, Volume 8, No. 7, Article e70713, Year 2013
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Description
Background:The Affordable Medicines Facility-malaria (AMFm) is a pilot program that uses price subsidies to increase access to Artemisinin Combination Therapies (ACTs), currently the most effective malaria treatment. Recent evidence suggests that availability and affordability of ACTs in retail sector drug shops (where many people treat malaria) has increased under the AMFm, but it is unclear whether household level ACT use has increased.Methods and Findings:Household surveys were conducted in two remote regions of Tanzania (Mtwara and Rukwa) in three waves: March 2011, December 2011 and March 2012, corresponding to 3, 13 and 16 months into the AMFm implementation respectively. Information about suspected malaria episodes including treatment location and medications taken was collected. Respondents were also asked about antimalarial preferences and perceptions about the availability of these medications. Significant increases in ACT use, preference and perceived availability were found between Rounds 1 and 3 though not for all measures between Rounds 1 and 2. ACT use among suspected malaria episodes was 51.1% in March 2011 and increased by 10.9 percentage points by Round 3 (p =. 017). The greatest increase was among retail sector patients, where ACT use increased from 31% in Round 1 to 49% in Round 2 (p =. 037) and to 61% (p<.0001) by Round 3. The fraction of suspected malaria episodes treated in the retail sector increased from 30.2% in Round 1 to 46.7% in Round 3 (p =. 0009), mostly due to a decrease in patients who sought no treatment at all. No significant changes in public sector treatment seeking were found.Conclusions:The AMFm has led to significant increases in ACT use for suspected malaria, especially in the retail sector. No evidence is found supporting the concerns that the AMFm would crowd out public sector treatment or neglect patients in remote areas and from low SES groups. © 2013 Cohen et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3726608/bin/pone.0070713.s001.docx
Authors & Co-Authors
Cohen, Jessica L.
United States, Boston
Harvard T.h. Chan School of Public Health
United States, Washington, D.c.
The Brookings Institution
Yadav, Prashant
United States, Ann Arbor
Stephen M. Ross School of Business
Moucheraud, Corrina
United States, Boston
Harvard T.h. Chan School of Public Health
Alphs, Sarah
United States, Ann Arbor
Stephen M. Ross School of Business
Larson, Peter S.
United States, Ann Arbor
Stephen M. Ross School of Business
Arkedis, Jean
United States, Washington, D.c.
Results for Development
Massaga, Julius John
Tanzania, Tanga
National Institute for Medical Research Tanga
Sabot, Oliver
United Kingdom, London
Slingshot Publications
Statistics
Citations: 24
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pone.0070713
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Violence And Injury
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Tanzania