In Nigeria, MalariaCare is partnering with the National Malaria Control Program, the Expanded Social Marketing Project in Nigeria led by Society for Family Health, the Ministry of Health, and Ebonyi state health authorities. The partnership aims to implement, evaluate, and demonstrate the effectiveness of a training and mentorship pilot for private sector health providers, known as Proprietary Patent Medicine Vendors (PPMVs). The purpose of the pilot is to improve PPMVs ability to manage cases of malaria, and other febrile illnesses, in accordance with national health standards.
Context for MalariaCare in Nigeria
With an estimated 170 million people, Nigeria is home to nearly one-sixth of the African continent’s population, and accounts for nearly 25 percent of the malaria burden in Africa. Nigeria’s Malaria Indicator Survey (MIS), conducted in 2010, found that the majority of households (57 percent) received treatment from a PPMV, while roughly 25 percent received treatment from public sector providers.
While the Nigerian Federal Ministry of Health has made major strides in malaria control, strengthening collaboration across Nigeria’s health sectors remains a high priority. In Ebonyi state, roughly 1.3 million citizens visit PPMVs for various issues ranging from colds to cases of severe malaria.
The primary aim of MalariaCare’s pilot evaluation in Nigeria is to support the Federal Ministry of Health in demonstrating whether, in a given area, PPMVs can be trained and mentored to provide effective case management of fever-related illnesses. Effective case management includes appropriate use of rapid diagnostic tests (RDTs), oral rehydration salts, zinc, and artemisinin-based combination therapy. MalariaCare will evaluate the pilot to demonstrate if training and support results in measurable increases in household uptake of life-saving child health interventions.
MalariaCare’s efforts in Nigeria aim to achieve the following objectives:
- Collaborate with the Society for Family Health to design, implement, and evaluate a pilot project to demonstrate the ability of private providers/PPMVs to provide quality services that are in line with national public health policies;
- Evaluate the impact of improved access to, and availability of high-quality malaria diagnostic services and treatment;
- Generate data to help inform national decisions regarding scale up efforts to engage PPMVs through analysis and dissemination of pilot results, including a combined analysis of household survey, outlet survey, and provider competence data.
Piloting integrated community case management among private providers. To serve the high percentage of patients seeking care at local pharmacies, MalariaCare is evaluating effectiveness of training PPMVs to provide quality case management services for malaria and other fever-related illness. This pilot project aims to demonstrate whether, in select areas in Ebonyi state, increasing the number of points-of-services (POS) that provide correct case management of fever-related illnesses (using rapid diagnostic tests (RDTs), ORS, zinc, and ACTs), results in a measurable increase in household uptake of these life-saving interventions. MalariaCare will evaluate differences in provider knowledge and ability to provide quality case management care before and after the pilot training and mentorship.
To assess the quality of household-level case management, the project will compare house-hold level information with areas that are not receiving project support. Project data is being used to provide local decision makers with important evidence on the contributions of these providers to malaria services.
“…PPMVs tend to treat a significant number of people who need healthcare…it is at this grass root level of healthcare where there is either cure, or mismanagement. When your mandate captures such people, it brings recognition to this cadre of healthcare workers, increases their capacity and improves health…Once we increase their capacity, we can bridge the gap of all level of healthcare. What we are doing to address malaria, even in the capacity building, has yielded results…I would like to continue to partner with such programs.”
Dr. Suny Nwangele, State Commissioner of Health, Ebonyi state
Nigeria case study: Real-time data improves quality of care in rural Nigeria pdf (468K)