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Evaluating Different Dimensions of Programme Effectiveness for Private Medicine Retailer Malaria Control Interventions in Kenya

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  • Timothy O Abuya
  • Greg Fegan
  • Abdinasir A Amin
  • Willis S Akhwale
  • Abdisalan M Noor
  • Robert W Snow
  • Vicki Marsh
Abstract
Background: Private medicine retailers (PMRs) are key partners in the home management of fevers in many settings. Current evidence on effectiveness for PMR interventions at scale is limited. This study presents evaluation findings of two different programs implemented at moderate scale targeting PMRs for malaria control in the Kisii and Kwale districts of Kenya. Key components of this evaluation were measurement of program performance, including coverage, PMR knowledge, practices, and utilization based on spatial analysis. Methodology/Principal Findings: The study utilized mixed quantitative methods including retail audits and surrogate client surveys based on post-intervention cross-sectional surveys in intervention and control areas and mapping of intervention outlets. There was a large and significant impact on PMR knowledge and practices of the program in Kisii, with 60.5% of trained PMRs selling amodiaquine medicines in adequate doses compared to 2.8% of untrained ones (OR; 53.5: 95% CI 6.7, 428.3), a program coverage of 69.7% targeted outlets, and a potential utilization of about 30,000 children under five. The evaluation in Kwale also indicates a significant impact with 18.8% and 2.3% intervention and control PMRs selling amodiaquine with correct advice, respectively (OR; 9.4: 95% CI 1.1, 83.7), a program coverage of 25.3% targeted outlets, and a potential utilization of about 48,000 children under five. A provisional benchmark of 7.5 km was a reasonable threshold distance for households to access PMR services. Conclusions/Significance: This evaluation show that PMR interventions operationalized in the district level settings are likely to impact PMR knowledge and practices and lead to increased coverage of appropriate treatment to target populations. There is value of evaluating different dimensions of public health programs, including quality, spatial access, and implementation practice. This approach strengthens the potential contribution of pragmatic study designs to evaluating public health programs in the real world.

Suggested Citation

  • Timothy O Abuya & Greg Fegan & Abdinasir A Amin & Willis S Akhwale & Abdisalan M Noor & Robert W Snow & Vicki Marsh, 2010. "Evaluating Different Dimensions of Programme Effectiveness for Private Medicine Retailer Malaria Control Interventions in Kenya," PLOS ONE, Public Library of Science, vol. 5(1), pages 1-9, January.
    • Handle: RePEc:plo:pone00:0008937
    DOI: 10.1371/journal.pone.0008937
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    References listed on IDEAS

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    2. Sarah V Kedenge & Beth P Kangwana & Evelyn W Waweru & Andrew J Nyandigisi & Jayesh Pandit & Simon J Brooker & Robert W Snow & Catherine A Goodman, 2013. "Understanding the Impact of Subsidizing Artemisinin-Based Combination Therapies (ACTs) in the Retail Sector – Results from Focus Group Discussions in Rural Kenya," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-10, January.
    3. Jinkou Zhao & Marcel Lama & Eline Korenromp & Patrick Aylward & Estifanos Shargie & Scott Filler & Ryuichi Komatsu & Rifat Atun, 2012. "Adoption of Rapid Diagnostic Tests for the Diagnosis of Malaria, a Preliminary Analysis of the Global Fund Program Data, 2005 to 2010," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-5, August.
    4. Stéphanie Siron & Christian Dagenais & Valéry Ridde, 2015. "What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(7), pages 849-863, November.

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