Access of the Poor to Quality Malaria Drugs

The Future Health Systems (FHS) Research Programme Consortium aims to find ways to translate political and financial commitments to meet the health needs of the poor. The consortium addresses fundamental questions about the design of future health systems, and work closely with actors who are leading the transformation of health systems in their new realities. This consortium addresses fundamental questions about the design of future health systems, and works closely with people who are leading the transformation of health systems in their own countries. FHS research themes are:

  • Protecting the poor against the impact of health-related shocks
  • Developing innovations in health provision
  • Understanding health policy processes and the role of research

Eight partners in eight different countries are exploring various ways to make health systems work for the poor. The team based at the University of Ibadan, Nigeria, has been exploring the role of Patent Medicine Vendors (PMVs) in providing quality, appropriate malaria treatment in the poor communities where they are based. A recent workshop analyzed and wrote a working paper based on the first-year scoping study.

Several key aspects of PMV behavior and knowledge were identified. “This study has documented the problems that people have in getting access to appropriate treatment for malaria. They have little knowledge of the changing patterns of drug resistance and the consequent changes in the drugs that are effective. They must rely either on traditional practices or on the advice of the people who provide the drugs. Since patent medicine vendors provide anti-malarial treatment in a substantial proportion of cases, their knowledge and practice strongly influence people’s wellbeing. This study made two major findings about this knowledge and practice. First, patent medicine vendors have little knowledge about new guidelines for drug use and they still recommend that people use drugs whose efficacy is doubtful. Second, there is a lot of concern about the quality of the drugs they supply. Action is needed to address these problems.”

Watch here as well as the FHS website for further updates on this important research that documents the challenges of a major informal provider, the patent medicine vendor, who has been ignored in formulating malaria access policy. In fact the 2003 Nigeria Demographic and Health Survey found that only about 25% of parents sought malaria treatment for their children in the formal sector. The few efforts to train and upgrade PMVs has been documented by BASICS, but more needs to be done if malaria drugs are going to reach all.

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dscn1465.JPGAs a note of interest, the previous entry here on Kenya’s looming drug shortage was filed from one of only two cyber cafes in the town of Igbo-Ora in southwest Nigeria pictured here. The town has 60,000 residents, but electricity is erratic to rare. It took several visits to find that the cafe’s generator was working strongly enough to access this site and make a posting. That is life on the edge of the digital divide. This current posting is being made at the airport lounge in Lagos on wireless connection – shows how the average person in Africa has little access to the internet to gather malaria information and engage in malaria advocacy.

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