The Malaria Testing and Treatment Market in Kinshasa, Democratic Republic of the Congo, 2013

Background The Democratic Republic of Congo (DRC) is one of the two most leading contributors to the global burden of disease due to malaria. This paper describes the malaria testing and treatment market in the nation’s capital province of Kinshasa, including availability of malaria testing and treatment and relative anti-malarial market share for the public and private sector. Methods A malaria medicine outlet survey was conducted in Kinshasa province in 2013. Stratified multi-staged sampling was used to select areas for the survey. Within sampled areas, all outlets with the potential to sell or distribute anti-malarials in the public and private sector were screened for eligibility. Among outlets with anti-malarials or malaria rapid diagnostic tests (RDT) in stock, a full audit of all available products was conducted. Information collected included product information (e.g. active ingredients, brand name), amount reportedly distributed to patients in the past week, and retail price. Results In total, 3364 outlets were screened for inclusion across Kinshasa and 1118 outlets were eligible for the study. Among all screened outlets in the private sector only about one in ten (12.1%) were stocking quality-assured Artemisinin-based Combination Therapy (ACT) medicines. Among all screened public sector facilities, 24.5% had both confirmatory testing and quality-assured ACT available, and 20.2% had sulfadoxine-pyrimethamine (SP) available for intermittent preventive therapy during pregnancy (IPTp). The private sector distributed the majority of anti-malarials in Kinshasa (96.7%), typically through drug stores (89.1% of the total anti-malarial market). Non-artemisinin therapies were the most commonly distributed anti-malarial (50.1% of the total market), followed by non quality-assured ACT medicines (38.5%). The median price of an adult quality-assured ACT was $6.59, and more expensive than non quality-assured ACT ($3.71) and SP ($0.44). Confirmatory testing was largely not available in the private sector (1.1%). Conclusions While the vast majority of anti-malarial medicines distributed to patients in Kinshasa province are sold within the private sector, availability of malaria testing and appropriate treatment for malaria is alarmingly low. There is a critical need to improve access to confirmatory testing and quality-assured ACT in the private sector. Widespread availability and distribution of non quality-assured ACT and non-artemisinin therapies must be addressed to ensure effective malaria case management

Madagascar (2013): [Evaluation study] Comparing women exposed to the campaign of IUD versus those not exposed in three zones of Madagascar (Antananarivo, Mahajanga and Toamasina).

In 2008, PSI/Madagascar started its Women's Health Project that focuses on the promotion of family planning long term methods such as IUD and Implant to contribute on improving the health of women of reproductive age, and to reduce the maternal mortality rate. From 4th May to 21st May 2013 and from 5th August to 14th August 2013, PSI/M conducted a campaign about IUD through a TV, radio and IPC activities performed by the family planning counselor. The Post-Campaign study determines the impact of the campaign on the reproductive women targeted

Madagascar (2013): [ACTWatch Outlet Survey] measuring [the availability, price and market share of antimalarials and RDT] among [potential providers] in [Malaria endemic area]. Round [1].

The Madagascar ACTWatch outlet survey aims to determine the availability, the price and the market share of antimalarials and RDTs in endemic area in Madagascar. All potentials outlets, including public health facilities, private health facilities, non-profit facilities or organization, pharmacies, "depots de medicaments" and informal outlets as groceries are approached. 12 urban communes and 32 rural communes are selected where all potential outlets are censused. Booster outlets of publics health facilities, pharmacies and "depots de medicaments" are also visite

Madagascar (2013): Provider study measuring General Motivation among Top Reseau providers and Knowledge and Attitudes towards IUD among FP providers in Madagascar. Round 1.

As part of its activities to support and strengthen the social franchise's overall performance (in terms of access, quality, product/service portfolio, equity etc), PSI/Madagascar is continuously looking for ways to improve its provider motivation strategy. Under the new Integrated Social Marketing Program (2013-2017) PSI/Madagscar explored ways to maintain and improve provider motivation and quality of service delivery. The Woman's Health Project (WHP) aims to increase the use of IUDs in Madagascar through private and public sector redynamisation. The provider motivation survey was conducted to answer questions motivational or other (socio-demographic) factors that may be correlated with provider performance. This survey established baselines estimates relating to the motivation and barriers. Provider's knowledge and attitude on IUD were also measured

Madagascar (2010-2011): MAP Study Evaluating the Availability of Pilplan and Confiance in Madagascar. Baseline.

The main objective for this study is to monitor geographic coverage and quality of coverage of Pilplan and Confiance within six supervision areas. In addition, the study also estimates levels of penetration (by outlet type). This is a MAP for coverage measuring coverage and quality of coverage. For rural areas, the study uses the Lot Quality Assurance Sampling (LQAS) technique to draw a random sample of 19 communes from six rural supervision zones. For urban area, an exhaustive sample methodology (census) was adopted, because in each zone there are less than 19 urban communes

Madagascar (2014): TRaC Survey measuring Consistent condom use, STI treatment seeking and HIV Counselling and Testing among Female Sex Workers in Urban areas of Madagascar

The prevalence of HIV/AIDS remains low in Madagascar among the general population (UNAIDS) but many risk factors exist that contribute to the potential risk of an epidemic spreading into the general population. Resulted from these risk factors, HIV/AIDS & STI Prevention targets female sex workers (FSW) with a focus on target urban areas. TRaC Female Sex Workers surveys are used to collect cross sectional data in order to provide actionable evidence decision making as well as helping to measure the impact of various project interventions and activities. TRaC FSW survey aims i) to monitor over time, the levels and trends in key behaviors (condom use among FSWs, STI treatment seeking and HIV counseling and Testing) and behavioral factors ii) to determine the factors associated with condom use among FSWs, with STI treatment seeking and with HIV counseling and Testing and iii) to assess the impact of HIV/AIDS prevention intervention among FSW

Facteurs associés à une première grossesse chez les femmes Malgaches ayant accouché dans un hôpital de maternité d'Antananarivo: une étude de cohorte rétrospective

Introduction: Il y a très peu de littératures africaines et Malgaches concernant les détails sur les facteurs de risques qu'encourent les primigestes en général. Le but de notre étude est de déterminer les facteurs de risques potentiels associés à une première grossesse. Méthodes: Une étude cohorte rétrospective a été menée auprès des femmes primigestes et multigestes de l'hôpital Pavillon sainte Fleur entre Octobre 2014 et Décembre 2016. Les risques relatifs étaient ajustés après contrôle avec les caractéristiques sociodémographiques. Résultats: Les primigestes étaient beaucoup plus exposées à un travail prolongé de plus de 12h (RRa = 2,28; IC 95% 1,74-3,00), à une césarienne en urgence (RRa = 1,47; IC 95% 1,35-1,60) et à une épisiotomie (RRa = 2,98; IC 95% 2,61-3,40). Leurs enfants étaient plus susceptibles de présenter des signes de souffrance foetale avec anomalie du rythme cardiaque foetale au cours de la phase de travail (RRa = 1,96; IC 95% 1,45-2,65) et un risque accru d'être admis dans une unité de soins intensifs après l'accouchement (RRa = 2,08; IC 95% 1,25-3,45). Conclusion: Les complications survenues pendant le travail auraient exposé les primigestes à d'autres risques en cascades sur l'issue de leurs accouchements et sur la santé de leurs enfants. La prise en charge des primigestes nécessiterait, de la part des personnels médicaux, une attention particulière sur la durée de la phase de travail

Nigeria (2015): FPwatch Family Planning Outlet Survey

FP watch is a multi-country research project implemented by PSI with funding from The Bill and Melinda Gates Foundation (BMGF), UNITAID, and DFID. The objective of the FPwatch study in Nigeria is to provide information relevant for policy, strategy, and funding decisions about malaria and family planning markets