Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot study

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dc.contributor.authorTalisuna, Ambrose O.
dc.contributor.authorDaumerie, Penny Grewal
dc.contributor.authorBalyeku, Andrew
dc.contributor.authorEgan, Timothy
dc.contributor.authorPiot, Bran
dc.contributor.authorCoghlan, Renia
dc.contributor.authorLugand, Maud
dc.contributor.authorBwire, Godfrey
dc.contributor.authorRwakimari, John Bosco
dc.contributor.authorNdyomugyenyi, Richard
dc.contributor.authorKato, Fred
dc.contributor.authorByangire, Maria
dc.contributor.authorKagwa, Paul
dc.contributor.authorSebisubi, Fred
dc.contributor.authorNahamya, David
dc.contributor.authorBonabana, Angela
dc.contributor.authorMpanga-Mukasa, Susan
dc.contributor.authorBuyungo, Peter
dc.contributor.authorLukwago, Julius
dc.contributor.authorBatte, Allan
dc.contributor.authorNakanwagi, Grace
dc.contributor.authorTibenderana, James
dc.contributor.authorNayer, Kinny
dc.contributor.authorReddy, Kishore
dc.contributor.authorDokwal, Nilesh
dc.contributor.authorRugumambaju, Sylvester
dc.contributor.authorKidde, Saul
dc.contributor.authorBanerji, Jaya
dc.contributor.authorJagoe, George
dc.date.accessioned2018-05-17T11:31:27Z
dc.date.available2018-05-17T11:31:27Z
dc.date.issued2012-10-29
dc.descriptionThe study examined closing the access barrier for effective anti-malarials in the private sector in rural Ugandaen_US
dc.description.abstractBackground: Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa. Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to ACT in the private sector could be improved through the provision of a high level supply chain subsidy. Methods: Four intervention districts were purposefully selected to receive branded subsidized medicines - “ACT with a leaf”, while the fifth district acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at licensed and unlicensed drug outlets in the intervention and control districts. A survey-adjusted, multivariate logistic regression model was used to analyse the intervention’s impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. Results: At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, “ACT with a leaf” accounted for 69% of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8% at baseline to 26.2% (95% CI: 23.2-29.2%) at evaluation in the intervention districts. In the control district, it rose modestly from 1.8% to 5.6% (95% CI: 4.0-7.3%). The odds of purchasing ACT within 24 hours in the intervention districts compared to the control was 0.46 (95% CI: 0.08-2.68, p=0.4) at baseline and significant increased to 6.11 (95% CI: 4.32-8.62, p<0.0001) at evaluation. Children less than five years of age had “ACT with a leaf” purchased for them more often than those aged above five years. There was no evidence of price gouging. Conclusions: These data demonstrate that a supply-side subsidy and an intensive communications campaign significantly increased the uptake and use of ACT in the private sector in Uganda.en_US
dc.identifier.citationTalisuna, Ambrose O., Daumerie, Penny Grewal, Balyeku, Andrew, Egan, Timothy, Piot, Bram, Coghlan, Renia, Lugand, Maud, Bwire, Godfrey, Rwakimari, John Bosco, Ndyomugyenyi, Richard, Kato, Fred, Byangire, Maria, Kagwa, Paul, Sebisubi, Fred, Nahamya, David, Bonabana, Angela, Mpanga-Mukasa, Susan, Buyungo, Peter, Lukwago, Julius , Batte, Allan, Nakanwagi, Grace, Tibenderana, James, Nayer, Kinny, Reddy, Kishore, Dokwal, Nilesh,2012. Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot studyen_US
dc.identifier.urihttps://hdl.handle.net/20.500.11951/226
dc.language.isoenen_US
dc.publisherBioMed Central Ltden_US
dc.subjectFalciparum malariaen_US
dc.subjectArtemisinin-based combination therapyen_US
dc.subjectSubsidized medicinesen_US
dc.subject“ACT with a leaf”en_US
dc.subjectPrivate sectoren_US
dc.subjectAffordable medicines facility-malariaen_US
dc.subjectUgandaen_US
dc.titleClosing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot studyen_US
dc.typeArticleen_US
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The final, definitive version of this paper has been published in the Malaria Journal, Vol.11/Issue 356, 29, October 2012, https://doi.org/10.1186/1475-2875-11-356; published by BioMed Central Ltd. All rights reserved.
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