Background
Policy makers, governments and donors are faced with an information gap when considering ways to improve access to artemisinin-based combination therapy (ACT) and malaria diagnostics including rapid diagnostic tests (RDTs). To help address some of these gaps, a five-year multi-country research project called ACTwatch was launched. The project is being conducted in seven malaria-endemic countries: Benin, Cambodia, the Democratic Republic of Congo, Madagascar, Nigeria, Uganda and Zambia from 2008 to 2012.
Goals and Objectives
ACTwatch aims to provide a comprehensive picture of the markets for antimalarials and diagnostic tests in order to inform national and international malaria case management policy decision-making. It does so by studying both the demand and supply sides of the markets.
- Market share, price and availability of different antimalarials and diagnostic tests in public facilities and private retail outlets. Provider knowledge and attitudes are also assessed.
- Private sector distribution serving these outlets, mapping out the supply chain and the mark-ups levied across each level.
- Treatment seeking patterns for fever and use of antimalarial drugs and diagnostic tests for malarial.
An additional objective of ACTwatch is to ensure that policy makers at both the national and international level have access to our findings through dissemination.
Study Components
Outlet Survey (PSI): Monitor trends in the availability, volume and price of antimalarials in the public and private sectors, which includes the informal sector. The survey is nationally representative and encompasses all public and private outlet types with the potential to stock antimalarials (from hospitals to private pharmacies to street hawkers). The survey is conducted periodically over the life of the project.
Household Survey (PSI): Examine trends in the levels of household use of different antimalarials, their source, timing of treatments and whether diagnostic testing for malaria was done. The survey is nationally representative, and is conducted at baseline and endline.
Supply Chain Research (LSHTM): Identify the determinants of the price and availability of antimalarials at different levels of the supply chain, including markups at each level. The study collects nationally representative information along the supply chain from importer/manufacturer to retailer using a systematic sampling approach, and a structured survey alongside qualitative research methods.
PSI country offices in each of the seven study countries provide the required capacity fundamental to successful project implementation. In addition, these offices leverage well-established relationships with local government policymakers, and other relevant stakeholders to facilitate the achievement of project objectives.
