Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda

Malaria Journal

Research

William Dickens¹  Alex Cox²  Jessica Cohen²  Günther Fink²  Felix Lam³  Kathleen Maloney⁴ 

[1] Department of Economics, Northeastern University, Boston, MA, USA;Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA;Essential Medicines Team, Clinton Health Access Initiative, Boston, MA, USA;Malaria Control Team, Clinton Health Access Initiative, Boston, MA, USA;

关键词: Malaria;    Rapid diagnostic test;    RDT;    Diagnostics;    Drug shop;    Private sector;    Acceptability;    Uptake;    Uganda;   

DOI  :  10.1186/s12936-015-0590-x

 received in 2014-09-08, accepted in 2015-01-28,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn Uganda, as in most other malaria-endemic countries, presumptive treatment for malaria based on symptoms without a diagnostic blood test is still very common. While diagnostic testing in public sector facilities is increasing, many people in Uganda who suspect malaria visit private sector outlets to purchase medications. Increasing the availability and uptake of rapid diagnostic tests (RDTs) for malaria in private outlets could help increase diagnostic testing for malaria but raises questions about the patient demand for and valuation of testing that are less critical for public sector introduction.MethodsIn preparation for a behaviour change campaign to encourage and sustain the demand for RDTs in drug shops, eight focus group discussions with a total of 84 community members were conducted in six districts across Uganda’s Eastern Region in November-December 2011. Focus groups explored incentives and barriers to seeking diagnosis for malaria, how people react to test results and why, and what can be done to increase the willingness to pay for RDTs.ResultsOverall, participants were very familiar with malaria diagnostic testing and understood its importance, yet when faced with limited financial resources, patients preferred to spend their money on medication and sought testing only when presumptive treatment proved ineffective. While side effects did seem to be a concern, participants did not mention other potential costs of taking unnecessary or ineffective medications, such as money wasted on excess drugs or delays in resolution of symptoms. Very few individuals were familiar with RDTs.ConclusionIn order to boost demand, these results suggest that private sector RDTs will have to be made convenient and affordable and that targeted behaviour change campaigns should strive to increase the perceived value of diagnosis.

【 授权许可】

CC BY   
© Cohen et al.; licensee BioMed Central. 2015