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Table 1 Lessons learnt from literature reviews and formative research

From: Designing and implementing interventions to change clinicians’ practice in the management of uncomplicated malaria: lessons from Cameroon

Literature reviews

Formative research

Barriers to the implementation of malaria case management in Cameroon

Interventions to improve clinicians’ practice in treating uncomplicated malaria

Quantitative

Qualitative

• Lack of knowledge of the recommended doses for ACT

• Positive effect on presumptive treatment of febrile patients, and the accuracy of the doses and advice given

• Malaria prevalence

• Heterogeneous definition of malaria

• Pressure to use supplied drugs from governing medical boards of mission facilities

• Provision of RDTs and training on diagnostic tests led to improvements in the appropriate treatment of malaria

• Over-prescription of anti-malarials

• Heterogeneous treatment for malaria

• Pressure from pharmaceutical marketing agents, providers and community preference of anti-malarial drugs,

• Difficult to draw conclusions from the economic interventions given the limitations of the study design and data available

• Reliance on presumptive diagnosis

• Malaria is an acceptable disease.

• Few in-service and pre-service training packages and the availability of drug in stock

• None of the studies compared the implementation of an intervention across public and private sector providers

• Availability of testing and ACT

• Broad role of anti-malarials

• Delivery of ACT to health facilities governed by a plethora of factors ranging from administrative hitches to the absence of an efficient monitoring and evaluation system

  

• Discrete roles of malaria tests

• Lack of adequate funding for large scale subsidies and inequity in the subsidization rate of ACT between public and private facilities

   
  1. Legend: Lessons learnt from literature reviews and formative research during the process of designing an intervention to improve clinicians’ practice in the management of uncomplicated malaria. ACT = artemisinin based combination therapy.