The Bulletin, Off-Campus Courses and Extension Services 1964-1966, Volume 64, Number 4, June (1964)

https://red.mnstate.edu/bulletins/1043/thumbnail.jp

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

South Sudan (2012): How can LLIN usage be increased in rural South Sudan? Qualitative Study for Marketing Planning

This study explored determinants identified in the South Sudan Malaria Indicator Survey (SSMIS), undertaken by the Government of South Sudan and supported by PSI Sudan and other partners in December 2009. The SSMIS was based on responses from 2,797 parents or care takers of children under five across South Sudan. Little research has been conducted to explore behavioral determinants of LLIN use and general perceptions of LLINs in South Sudan. Anecdotal evidence suggests that rates of LLIN misuse are high in South Sudan, thus collecting insight on malaria perceptions in general and LLIN use specifically is a high priority for designing effective, context-appropriate malaria prevention programs. This study therefore contributes to a greater understanding of how pregnant women and caretakers of children under 5 understand malaria and LLIN usage. STUDY OBJECTIVES Designing a concept to socially market a health product requires familiarity with the target audience and the context in which behavior change takes place. The purpose of this study was to provide information that can be used to improve key messages and IEC materials aimed at increasing the usage of LLI Ns that are being distributed throughout South Sudan. Specifically, the study objectives were to: a. Identify beliefs to reinforce and beliefs to change related to the use of LLINs amongst pregnant women and caregivers of children under 5; b. Describe the openings when, where, how and by whom pregnant women and caregivers can be effectively communicated with; c. Describe pregnant mothers' and caregivers' past experiences with the desired behavior and alternative behaviors; d. Describe the level of knowledge and sophistication of knowledge that pregnant women and caregivers have of malaria transmission; and, e. Understand the association that pregnant women and caregivers have with LLINs and their usage

Getting to FP2020: Harnessing the private sector to increase modern contraceptive access and choice in Ethiopia, Nigeria, and DRC.

An estimated 214 million women have unmet need for family planning in developing regions. Improved utilization of the private sector is key to achieving universal access to a range of safe and effective modern contraceptive methods stipulated by FP2020 and SDG commitments. Until now, a lack of market data has limited understanding of the private sector's role in increasing contraceptive coverage and choice.In 2015, the FPwatch Project conducted representative outlet surveys in Ethiopia, Nigeria, and DRC using a full census approach in selected administrative areas. Every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, availability, and price.Excluding general retailers, 96% of potential outlets in Ethiopia, 55% in Nigeria, and 41% in DRC had modern contraceptive methods available. In Ethiopia, 41% of modern contraceptive stocking outlets were in the private sector compared with approximately 80% in Nigeria and DRC where drug shops were dominant. Ninety-five percent of private sector outlets in Ethiopia had modern contraceptive methods available; 37% had three or more methods. In Nigeria and DRC, only 54% and 42% of private sector outlets stocked modern contraceptives with 5% and 4% stocking three or more methods, respectively. High prices in Nigeria and DRC create barriers to consumer access and choice.There is a missed opportunity to provide modern contraception through the private sector, particularly drug shops. Subsidies and interventions, like social marketing and social franchising, could leverage the private sector's role in increasing access to a range of contraceptives. Achieving global FP2020 commitments depends on the expansion of national contraceptive policies that promote greater partnership and cooperation with the private sector and improvement of decisions around funding streams of countries with large populations and high unmet need like Ethiopia, Nigeria, and DRC

Total outlets screened (potential market) and eligible (actual market), by country and outlet type.

<p>Total outlets screened (potential market) and eligible (actual market), by country and outlet type.</p

Leveraging long acting reversible contraceptives to achieve FP2020 commitments in sub-Saharan Africa: The potential of implants

<div><p>Background</p><p>In developing regions, an estimated 214 million women have an unmet need for family planning. Reaching Family Planning 2020 (FP2020) commitments will require a shift in modern contraceptive promotion, including improved access to long-acting reversible contraceptives (LARCs). Until now, a lack of market data limited understanding of the potential of LARCs to increase contraceptive access and choice.</p><p>Methods</p><p>From 2015, the FPwatch Project conducted representative surveys in Ethiopia, Nigeria, and Democratic Republic of Congo (DRC) using a full census approach in selected administrative areas. In these areas, every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, market share, availability, price, and outlet readiness to perform services.</p><p>Results</p><p>Fifty-four percent of outlets in Ethiopia had LARC commodities or services available at the time of the survey, versus 7% and 8% of outlets in Nigeria and DRC, respectively. When present, LARCs were usually available with at least two other methods (99%, 39%, and 84% of public health facilities in Ethiopia, Nigeria and DRC, respectively). Many public facilities had both implants and IUDs in stock (76%, 47%, and 53%, respectively). Lack of readiness to provide LARCs was mostly due to a lack of equipment, private room, or the commodity itself. Market share for implants in the public sector was 60%, 53%, and 37% of Couple Years of Protection (CYP) in Ethiopia, Nigeria, and DRC.</p><p>Discussion</p><p>Limited availability of LARCs in Nigeria and DRC restricts contraceptive choice and makes it difficult for women to adopt and use modern contraception consistently. Brand-specific subsidies, task shifting, and promotion of methods that require less equipment and training are promising strategies for increasing uptake. Substantial government investment is required to improve availability and affordability. Investment in implants should be prioritized to make progress towards FP2020 commitments.</p></div

Availability of selected LARC methods on the day of the survey among all screened outlets excluding general retailers, by country and outlet type.

<p>Availability of selected LARC methods on the day of the survey among all screened outlets excluding general retailers, by country and outlet type.</p

Availability of selected short-acting methods on the day of survey among all screened outlets excluding general retailers, by country and outlet type.

<p>Availability of selected short-acting methods on the day of survey among all screened outlets excluding general retailers, by country and outlet type.</p

Median consumer per-unit price of short-acting and LARC methods in USD in the private sector^*, by country and outlet type.

<p>Median consumer per-unit price of short-acting and LARC methods in USD in the private sector^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0192522#t002fn001" target="_blank">*</a>}, by country and outlet type.</p

Outlet category description by country.

<p>Outlet category description by country.</p