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Table 1 ACCESS Programme components and corresponding indicators for evaluation (refer to main text for details)

From: Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

Indicator Sources of verification/study methods Sample Timing
Intervention area 1: Behaviour change campaign
(Expected results: Improved health care seeking behaviour for all fever/malaria episodes)
Proportion of episodes treated according to national guidelines within 24 h Treatment-shift to qualified providers Cross-sectional community surveys (fever and degedege) with EMIC tool Random sample of households Repeated (baseline, mid-term, end)
  DSS (morbidity) and health facility attendance DSS area, all health facilities Continuous
Equitable access to appropriate treatment DSS SES data DSS area, all health facilities Continuous
Intervention area 2: Quality of care in health facilities (Expected results: Improved quality of care in health facilities, especially malaria case-management, incl. diagnosis, prescription, treatment, advice, compliance)
Proportion of episodes receiving correct prescription and appropriate advice Patient's satisfaction with services Quality of care surveys in health facilities Sample of health facilities Repeated (baseline, mid-term, end)
  QIRI All health facilities Continuous
Intervention area 3: Malaria case-management in shops
(Expected results: Improved quality of malaria case-management in drug selling shop, such as retailing practices, prescriptions, advice)
Proportion of episodes receiving correct prescription and appropriate advice Mystery shoppers All drug stores and random sample of general shops Annually
Shop-keepers' knowledge of malaria symptoms, correct treatment and advice Availability of first- and second-line antimalarial drugs Cross-sectional surveys in shops stocking drugs All retailers stocking drugs Annually
Shamba component
(Expected results: Coverage of appropriate malaria treatment and care services extended to underserved areas, incl. shamba households)
Proportion of households within 5 km range of qualified provider DSS GPS data All households, health facilities and shops stocking drugs Repeated
Proportion of episodes in underserved areas/poor households/shamba houses receiving correct treatment Cross-sectional community surveys (fever and degedege), DSS SES data Random sample of households Repeated (baseline, mid-term, end)
Health impact
(Expected results: Reduction of malaria related morbidity and mortality, especially in children under five and pregnant women)
Proportion of malaria-related deaths DSS mortality data: overall and cause-specific. All households Continuous
Number of fever episodes. DSS fever incidence All households Continuous
Additional studies
Understanding and perception of malaria, its treatment and prevention Focus-group discussions 10 groups of caretakers of children under five years in Ifakara and DSS Once prior to interventions
Risk factors for fatal outcome of degedege Case-control study Cases:degedege-related child deaths in DSS Controls: recovered degedege cases Once
Vulnerability and coping strategies of households during the farming season; movement patterns and health seeking Cohort study with shamba households Random sample of households with field (shamba) house Once
Antimalarial drug quality Cross-sectional survey All drug stocking retailers and health facilities Once
  1. EMIC = Explanatory Model Interview Catalogue. DSS = Demographic Surveillance System. SES = Socio-economic Status. QIRI = Quality Improvement and Recognition Initiative. GPS = Geographic Positioning System.