Understanding and Improving Access to Effective Malaria Treatment in Rural Tanzania (ACCESS Programme).

Sponsor: Novartis Foundation for Sustainable Development, Switzerland
IHRDC investigators: H Mshinda, A Makemba, K Sono & J Msechu
Partners: C Lengeler, B Obrist & M Hetzel, Swiss Tropical Institute

Many people in high risk malaria areas lack access to prompt and effective malaria treatment. Most episodes are either not treated at all, or the treatment is done at home with drugs purchased from private shops. Quality of services in health facilities is often poor. Various inter-linked factors influence successful care seeking, such as illness perception, socio-economic circumstances, geographic access, availability of drugs, etc.
ACCESS is a multi-disciplinary programme aiming at understanding these factors and developing a social marketing-based intervention to improve (1) malaria understanding and prompt action at household level, (2) quality of malaria care in health facilities, (3) prescription practices in commercial shops selling antimalarials. Surveys on all three intervention levels monitor success and impact of the intervention on morbidity, mortality and treatment seeking behaviour. Data collected through the local Demographic Surveillance System (DSS) provide the basic epidemiological framework. The programme is implemented in Kilombero and Ulanga Districts.