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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.