Although there is a growing commitment to fight malaria, adequate control measures remain a major challenge. One important problem is the lack of prompt and correct treatment of uncomplicated malaria - both at home and in health facilities. This project aims to evaluate, using a randomised-controlled design, the effectiveness of all cause mortality in the under-fives, and improve the case management of malaria in this age group through a consistent and complementary system comprising home and professional care through an interface of women’s groups, ‘Shared Care’. Health facility staff, women’s groups and mothers will be trained in Good Malaria Professional Practice and Good Malaria Self-Practice. Evaluation will be based on input, process and output indicators. Feedback will be via quarterly newsletters, meetings and publications.
The general objective of this research is to evaluate the effectiveness of ‘Shared Care’ intervention in Tanzania and Burkina Faso. This will be achieved by:
1) studying health-seeking practices regarding childhood malaria
2) describing current consumption of and resistance to antimalarials
3) assessing the quality of malaria case management in health facilities
4) designing and implementing the intervention
5) attributing changes in 1) through 3) to the intervention 4) in a randomised controlled design, and disseminate the progress and results to stakeholders.
The project is organised into ten work packages distributed over three phases, namely pre-intervention, intervention and evaluation. The work packages include overall research design, qualitative interviews, household surveys, pharmacological surveys, malaria surveys, observations of patient-provider interaction survey, community information systems, cost of intervention, the intervention itself, and feedback and dissemination. There is an initial workshop to refine and adapt tools and methods. The following baseline studies will then be conducted: household surveys to study mothers’ knowledge, health seeking behaviour and practices; qualitative interviews to assess the willingness of health professionals to participate in the scheme; pharmacological survey for the efficacy of antimalarial drug therapy and use in communities. In addition, there will be patient-provider interaction to assess the quality the interaction; and a malaria survey to establish the prevalence of malaria parasites and haematocrit levels. A community information system and costing of the intervention during its implementation will also be carried out.
The following are the milestones for the project: agreement of partners on research methods, concepts and tools; guidelines on good malaria management both at home and in health facilities; establishment of an effective development of internal coordination and management of the project; implementation of the ‘Shared Care’ intervention and its evaluation.
Klinikum der Universität Heidelberg
Tropenhygiene und Öffentlinches Gesundheitswesen
Tel: +49 62 2156 5038
Fax: +49 62 2156 5948