- Oral presentation
- Open Access
- Published:
Overcoming the affordability barrier for effective and high quality life saving malaria medicines in the private sector in rural Uganda: the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study
Malaria Journal volume 11, Article number: O16 (2012)
Background
Artemisinin-based combination therapies (ACTs), the treatment of choice for non-complicated falciparum malaria, are unaffordable and inaccessible in the private sector, yet the private sector is the first port of call for malaria treatment across most of 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 effective malaria treatment could be improved through the provision of highly subsidized ACTs in the private sector.
Methods
Four intervention districts (Pallisa, Budaka, Kamuli and Kaliro) were purposefully selected to receive branded subsidized medicines-”ACT with a leaf”, while the fifth district (Soroti) acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at all licensed private 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; access to ACTs within 24 hours of symptom-onset; and displacement of sub-optimal antimalarials.
Results
At baseline, the market share of ACTs was < 1%. However, at evaluation, “ACT with a leaf” had a market share of 69% in the interventions districts. Access to ACTs within 24 hours of symptom onset 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 modestly rose from 1.8% to 5.6% (95% CI: 4.0 - 7.3%). The odds of accessing ACTs within 24 hours in the intervention compared to the control districts was 0.46 (95% CI: 0.08 - 2.68, p = 0.4), at baseline and significantly increased to 6.11 (95% CI: 4.32 - 8.62, p < 0.0001) at evaluation. Children less than 5 years-old had “ACT with a leaf” purchased for them more often than those aged above 5 years. There was no evidence of price gouging.
Conclusions
Our data demonstrate that a supply-side antimalarial subsidy coupled with an intensive communications campaign significantly increased the uptake of ACTs in the private sector in Uganda.
Author information
Authors and Affiliations
Rights and permissions
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Talisuna, A.O., Grevval, P., Balyeku, A. et al. Overcoming the affordability barrier for effective and high quality life saving malaria medicines in the private sector in rural Uganda: the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study. Malar J 11 (Suppl 1), O16 (2012). https://doi.org/10.1186/1475-2875-11-S1-O16
Published:
DOI: https://doi.org/10.1186/1475-2875-11-S1-O16
Keywords
- Malaria
- Private Sector
- Malaria Treatment
- Exit Survey
- Intervention District