How can we engage the private sector for malaria case management? Lessons from programs in family planning and child health
The World Health Organization (WHO), aiming to tap the private health sector in an effort to reduce the burden of malaria, invited SHOPS Plus to show how private providers, especially drug sellers and pharmacists, have supported public health efforts. SHOPS Plus private sector specialist Sean Callahan and pharmacy and drug shop advisor Joseph Addo-Yobo shared lessons learned on engaging the private sector in family planning and child health at a WHO technical consultation on malaria case management in Geneva May 1-3, 2019.
The overall objective of the meeting was to examine the evidence on malaria case management in the private sector, look at the laws, regulations, and policies affecting malaria case management in priority countries, and to produce country-level frameworks for engaging the private sector in malaria.
Role of the private sector
Callahan set the context for private sector engagement by reviewing SHOPS Plus analysis of Demographic and Health Survey (DHS) data in priority countries. Globally, 35 percent of modern contraceptive users rely on private sector for their contraception method. For those seeking treatment or advice for childhood illnesses, including malaria, the role of the private sector is larger. Globally, 42 percent of caregivers rely on private sources for sick child care. The data show that private providers are an important source of care and they serve all income groups, including the poor. Yet, there are key barriers to fully integrating private providers into the health system. The first step is to understand the size and scope of the sector in a country. Examples of successful integration show that government stewardship is key.
Callahan outlined a number of policy barriers that can limit the integration into the health system of drug shops, often the first point of care. Acknowledging the need for quality services, he described other factors that need to be overcome to ensure quality such as inadequate training for drug dispensers, and the need to consider more than just clinical skills.
Addo-Yobo, who leads an Abt bilateral health project in Ghana that focuses on working with drug shops and pharmacies, discussed the public-private partnership SHOPS supported between the Pharmacy Council and private over-the-counter medicine sellers, as part of its comprehensive efforts to address diarrhea management. His presentation focused on the tools and activities undertaken to improve training and supportive supervision of these outlets for improved diarrhea management practices. Since the project ended, the gains the project made have been sustained. Sales of locally manufactured ORS and zinc products are strong. Ghana's Pharmacy Council continues to provide supportive supervision to the country’s more than 14,000 over-the-counter medicine sellers. The approach, which will be expanded into new areas, is documented in a short video.
As the global community seeks to control and eliminate malaria, lessons learned from other health areas could shed light on how to engage the private health sector, which plays an important role in provision of health services.