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Table 2 Summary of findings from country case studies

From: Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings

Country Malaria burden (2013) [223] National or regional elimination goal Private sector utilization Private sector engagement strategies for malaria
Diagnosis and case management Successes and challenges Case reporting Successes and challenges
Vietnam 35,406 cases and 6 deaths National elimination by 2015 No malaria-specific data available; over 60% of all outpatient care provided by private sector (as high as 80% for TB care) [224,225,226] Regulation by government Though Vietnam has an active social franchise network, it currently does not work with the NMCP
Engagement strategies have been employed in other programme areas and may serve as guide for malaria (e.g., total market approach for contraceptives, social franchising of private clinics, and TB PPPs)
None Malaria Information System does not include private providers
Experience with TB PPPs and private sector reporting of cases can be used as model
Cambodia 24,130 cases and 12 deaths Asia Pacific regional elimination by 2030 70% of malaria patients seek care in private sector; 75% of malaria treatment received from private sector [227] Regulation by government
Provider training
Social marketing
Social franchising
Increased crackdown on illegal drug outlets and establishment of drug inspection police to identify private pharmacies selling AMTs
Successful rollout of prepackaged, quality-assured ACT (i.e., Malarine)
Use of outlet survey results to guide policy formulation and interventions
Strengthened referral linkage between public and private providers through SMS system in pilot areas only
Trainings for private providers and regular meetings between public and private sectors in selected provinces
Private sector remains largely unregulated, particularly drug sellers and village vendors
Incentives needed to ensure proper testing and treatment even as cases decline
HMIS integration SMS system tracks private sector referrals to public facilities (in pilot areas only)
Myanmar 333,871 cases and 236 deaths Asia Pacific regional elimination by 2030 36% of malaria patients seek care in private sector; 65% of malaria treatment received from private sector [228, 229] Regulation by government
Provider training
Social marketing
Social franchising
Services and commodities sold by providers from two social franchise networks are regularly monitored and improved
Distribution of RDTs and provider training as part of the Myanmar Artemisinin Resistance Containment project
Successful rollout of Artemisinin Monotherapy Replacement project to increase quality-assured ACTs in private sector
None NGOs and private providers not formally integrated with HMIS, although changes are underway
Swaziland 669 cases and 4 deaths National elimination by 2015 No malaria-specific data available but private care minimal according to key informants None No law for government oversight of private sector exists
NMCP and partners have explored and addressed barriers to proper case management of malaria in the private sector; government and private providers have established communication channels
Notifiable or reportable disease list
HMIS integration
Provider trainings
Reporting malaria to HMIS and IDNS mandatory for all providers
In an effort to improve reporting rates, NMCP staff visit private providers and provider training on IDNS
Mozambique 3,924,832 cases and 2941 deaths Southern Africa regional elimination by 2030 No malaria-specific data available but private care minimal according to key informants; malaria testing services available in private sector but not ACT Regulation by government Unofficial partnerships between government and private companies (particularly extractive industry) exist Notifiable or reportable disease list No existing channels for routine reporting of malaria data among private providers
No law for mandatory reporting in place, therefore enforcement is poor
Zambia 5,465,122 cases and 3548 deaths Southern Africa regional elimination by 2030 7–10% of malaria patients seek care in private sector; 12–20% of malaria treatment received from private sector; [59] proportions are larger when church-run facilities, which provide 35% of all healthcare services, are considered [230, 231] Regulation by government
Accreditation of providers
Registered and licensed private drug shops allowed to stock and sell ACTs, based on positive findings of Zambia Access to ACTs Initiative HMIS integration Many small private clinics, health facilities, pharmacies, and shops excluded from national and district HMIS
  1. ACT artemisinin-based combination therapy, AMT artemisinin monotherapy, HMIS health management information system, IDNS Infection Diseases Notification System, NGO nongovernmental organization, NMCP National Malaria Control Programme, PPP public–private partnership, RDT rapid diagnostic test, SMS short message system, TB tuberculosis