Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.

<h4>Background</h4>Private medicine retailers (PMRs) are key partners in the home management of fevers in many settings. Current evidence on effectiveness for PMR interventions at scale is limited. This study presents evaluation findings of two different programs implemented at moderate...

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Main Authors: Timothy O Abuya, Greg Fegan, Abdinasir A Amin, Willis S Akhwale, Abdisalan M Noor, Robert W Snow, Vicki Marsh
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2010-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0008937&type=printable
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author Timothy O Abuya
Greg Fegan
Abdinasir A Amin
Willis S Akhwale
Abdisalan M Noor
Robert W Snow
Vicki Marsh
author_facet Timothy O Abuya
Greg Fegan
Abdinasir A Amin
Willis S Akhwale
Abdisalan M Noor
Robert W Snow
Vicki Marsh
author_sort Timothy O Abuya
collection DOAJ
description <h4>Background</h4>Private medicine retailers (PMRs) are key partners in the home management of fevers in many settings. Current evidence on effectiveness for PMR interventions at scale is limited. This study presents evaluation findings of two different programs implemented at moderate scale targeting PMRs for malaria control in the Kisii and Kwale districts of Kenya. Key components of this evaluation were measurement of program performance, including coverage, PMR knowledge, practices, and utilization based on spatial analysis.<h4>Methodology/principal findings</h4>The study utilized mixed quantitative methods including retail audits and surrogate client surveys based on post-intervention cross-sectional surveys in intervention and control areas and mapping of intervention outlets. There was a large and significant impact on PMR knowledge and practices of the program in Kisii, with 60.5% of trained PMRs selling amodiaquine medicines in adequate doses compared to 2.8% of untrained ones (OR; 53.5: 95% CI 6.7, 428.3), a program coverage of 69.7% targeted outlets, and a potential utilization of about 30,000 children under five. The evaluation in Kwale also indicates a significant impact with 18.8% and 2.3% intervention and control PMRs selling amodiaquine with correct advice, respectively (OR; 9.4: 95% CI 1.1, 83.7), a program coverage of 25.3% targeted outlets, and a potential utilization of about 48,000 children under five. A provisional benchmark of 7.5 km was a reasonable threshold distance for households to access PMR services.<h4>Conclusions/significance</h4>This evaluation show that PMR interventions operationalized in the district level settings are likely to impact PMR knowledge and practices and lead to increased coverage of appropriate treatment to target populations. There is value of evaluating different dimensions of public health programs, including quality, spatial access, and implementation practice. This approach strengthens the potential contribution of pragmatic study designs to evaluating public health programs in the real world.
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spelling doaj-art-5b004d6fe82344788f8a36ae192bdabf2025-08-20T02:31:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032010-01-0151e893710.1371/journal.pone.0008937Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.Timothy O AbuyaGreg FeganAbdinasir A AminWillis S AkhwaleAbdisalan M NoorRobert W SnowVicki Marsh<h4>Background</h4>Private medicine retailers (PMRs) are key partners in the home management of fevers in many settings. Current evidence on effectiveness for PMR interventions at scale is limited. This study presents evaluation findings of two different programs implemented at moderate scale targeting PMRs for malaria control in the Kisii and Kwale districts of Kenya. Key components of this evaluation were measurement of program performance, including coverage, PMR knowledge, practices, and utilization based on spatial analysis.<h4>Methodology/principal findings</h4>The study utilized mixed quantitative methods including retail audits and surrogate client surveys based on post-intervention cross-sectional surveys in intervention and control areas and mapping of intervention outlets. There was a large and significant impact on PMR knowledge and practices of the program in Kisii, with 60.5% of trained PMRs selling amodiaquine medicines in adequate doses compared to 2.8% of untrained ones (OR; 53.5: 95% CI 6.7, 428.3), a program coverage of 69.7% targeted outlets, and a potential utilization of about 30,000 children under five. The evaluation in Kwale also indicates a significant impact with 18.8% and 2.3% intervention and control PMRs selling amodiaquine with correct advice, respectively (OR; 9.4: 95% CI 1.1, 83.7), a program coverage of 25.3% targeted outlets, and a potential utilization of about 48,000 children under five. A provisional benchmark of 7.5 km was a reasonable threshold distance for households to access PMR services.<h4>Conclusions/significance</h4>This evaluation show that PMR interventions operationalized in the district level settings are likely to impact PMR knowledge and practices and lead to increased coverage of appropriate treatment to target populations. There is value of evaluating different dimensions of public health programs, including quality, spatial access, and implementation practice. This approach strengthens the potential contribution of pragmatic study designs to evaluating public health programs in the real world.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0008937&type=printable
spellingShingle Timothy O Abuya
Greg Fegan
Abdinasir A Amin
Willis S Akhwale
Abdisalan M Noor
Robert W Snow
Vicki Marsh
Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.
PLoS ONE
title Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.
title_full Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.
title_fullStr Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.
title_full_unstemmed Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.
title_short Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.
title_sort evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in kenya
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0008937&type=printable
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