Health service providers in Somalia: their readiness to provide malaria case-management

Malaria Journal

Table 2 Combined summaries of anti-malarial services provided by the public health service providers in the three study districts in Somalia

	Total
	Hospital/MCH-OP (n = 22)	HP (n = 23)	All (n = 45)
Reported use of anti-malarials for first-line treatment*
AS-SP	21 (95.5%)	0	21 (46.7%)
SP	0	7 (30.4%)	7 (15.6%)
Chloroquine	1 (4.5%)	16 (69.6%)	17 (37.8%)
Reported use of anti-malarials for second-line treatment**
Never use	1 (4.5%)	14 (63.6%)	15 (33.3%
Quinine	20 (91.0%)	2 (8.7%)	22 (48.9%)
SP	1 (4.5%)	7 (30.4%)	8 (17.8%)
Nationally recommended first-line therapy in stock on day of survey***	12 (54.5%)	3 (13.0%)	15 (33.3%)
Nationally recommended second-line therapy in stock on day of survey	19 (86.4%)	0	19 (42.2%)
Parasitological diagnosis****
None	2 (9.0%)	23 (100.0%)	25 (55.5%)
RDT	20 (91.0%)	0	20 (44.4%)
Microscopy	12 (54.5%)	0	12 (26.7%)
RDT in stock on day of survey	11 (50.0%)	0	11 (24.4%)
Revised national guidelines available at facility****	14 (63.6%)	0	14 (31.1%)
RDT use wall charts available at facility****	18 (81.8%)	0	18 (40.0%)
Anti-malarial dosing wall charts available at facility	18 (81.8%)	1 (4.3%)	19 (42.2%)
Charging for malaria consultation, diagnosis or treatment	8 (36.4%)	9 (39.1%)	17 (37.7%)

HP = health post; MCH/OP = Mother and Child Health/Out-patient facility; SP = sulphadoxine-pyrimethamine; AS-SP = artesunate and SP; RDT = rapid diagnostic test
*National treatment guidelines recommend AS-SP as first-line therapy in hospitals and MCH/OP facilities and SP at health posts.
** National treatment guidelines recommend Quinine as second-line therapy in hospitals and MCH/OP facilities. The guidelines also recommend that health posts refer patients to MCH/OP or hospitals in case of treatment failure with AS-SP.
***First-line drugs were considered out of stock if a hospital or MCH/OP facility did not have either AS or SP or both and if a health post did not have SP on the day of survey.
****National treatment guidelines recommend the use of RDT or microscopy for diagnosis of malaria at hospitals and MCH/OP while at health posts clinical diagnosis and presumptive treatment are recommended.

ISSN: 1475-2875