The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67757

Paula Tavrow, PhD¹, Waverly Rennie, MPH², Terry Wefwafwa³, and Tom Kangere³. (1) Department of Community Health Sciences, University of California, Los Angeles, P.O. Box 951772, Los Angeles, CA 90095-1772, 310-794-4302, ptavrow@ucla.edu, (2) Quality Assurance Project, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, (3) Bungoma District, Health Management Team, Ministry of Health, Bungoma, Kenya

About two-thirds of people in malaria endemic areas obtain their information and treatment from private drug outlets. But private sellers often lack knowledge and are influenced by advertising and profit motives. In early 2000, the Quality Assurance Project assisted the Bungoma District Health Management Team in western Kenya to introduce a “vendor-to-vendor” (VTV) strategy to increase private drug outlets’ compliance with national malaria treatment guidelines. The strategy involved training wholesale drug vendors to educate private retailers and to supply them with job aids. In late 2001, VTV was intensified and a complementary “neighbor-to-neighbor” component was added to increase consumers’ demand for approved anti-malarial drugs. This component involved enlisting villagers to educate each other about correct malaria treatment using a comic-book brochure and song contests. Both interventions were evaluated in May 2002 using mystery shoppers and household interviews. Altogether, shoppers visited 528 drug outlets, of which 147 had been reached by the VTV intervention. We found that 40% of intervention outlets versus 14% of comparison outlets sold mystery shoppers a recommended anti-malarial. Intervention outlets also had significantly better malaria knowledge and were more likely to tell shoppers the correct dosages. We also interviewed 661 randomly-selected households, of whom 54% had purchased malaria treatment in the past two weeks. Of the 61% who reported asking for a specific drug, 52% in intervention villages versus 10% in comparison villages requested an approved anti-malarial. Among those exposed to brochures or songs, 57% obtained acceptable drugs and dosages versus 35% of the non-exposed.

Learning Objectives:

• At the end of the session, participants will be able to:
• 1. Describe a “vendor-to-vendor” educational intervention that increased private outlets’ knowledge of and compliance with malaria treatment guidelines in one district of Kenya;
• 2. Describe a community-based “neighbor-to-neighbor” intervention that increased consumers’ demand for recommended anti-malarial drugs in the same district; and
• 3. Understand the limitations of district-level and community-based activities to influence private retail drug sellers and consumers.

Keywords: International Public Health, Community Education

Related Web page: www.qaproject.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.