Details:

Alternative Title:
Malar J
Personal Author:
Sidibe, Abigail ; Maglior, Alysse ; Cueto, Carmen ; Chen, Ingrid ; Le Menach, Arnaud ; ... More +
Sidibe, Abigail ; Maglior, Alysse ; Cueto, Carmen ; Chen, Ingrid ; Le Menach, Arnaud ; Chang, Michelle A. ; Eisele, Thomas P. ; Andrinopolous, Katherine ; Cherubin, Joseph ; Lemoine, Jean Frantz ; Bennett, Adam Less -
Description:
Background

Haiti and the Dominican Republic (DR) are targeting malaria elimination by 2022. The private health sector has been relatively unengaged in these efforts, even though most primary health care in Haiti is provided by non-state actors, and many people use traditional medicine. Data on private health sector participation in malaria elimination efforts are lacking, as are data on care-seeking behaviour of patients in the private health sector. This study sought to describe the role of private health sector providers, care-seeking behaviour of individuals at high risk of malaria, and possible means of engaging the private health sector in Hispaniola’s malaria elimination efforts.

Methods

In-depth interviews with 26 key informants (e.g. government officials), 62 private providers, and 63 patients of private providers, as well as 12 focus group discussions (FGDs) with community members, were conducted within seven study sites in Haiti and the DR. FGDs focused on local definitions of the private health sector and identified private providers for interview recruitment, while interviews focused on private health sector participation in malaria elimination activities and treatment-seeking behaviour of febrile individuals.

Results

Interviews revealed that self-medication is the most common first step in the trajectory of care for fevers in both Haiti and the DR. Traditional medicine is more commonly used in Haiti than in the DR, with many patients seeking care from traditional healers before, during, and/or after care in the formal health sector. Private providers were interested in participating in malaria elimination efforts but emphasized the need for ongoing support and training. Key informants agreed that the private health sector needs to be engaged, especially traditional healers in Haiti. The Haitian migrant population was reported to be one of the most at-risk groups by participants from both countries.

Conclusion

Malaria elimination efforts across Hispaniola could be enhanced by engaging traditional healers in Haiti and other private providers with ongoing support and trainings; directing educational messaging to encourage proper treatment-seeking behaviour; and refining cross-border strategies for surveillance of the high-risk migrant population. Increasing distribution of rapid diagnostic tests (RDTs) and bi-therapy to select private health sector facilities, accompanied by adopting regulatory policies, could help increase numbers of reported and correctly treated malaria cases.


Subject:
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Adult
Aged
Disease Eradication
Female
Focus Groups
Humans
Malaria, Falciparum
Male
Middle Aged
Patient Acceptance Of Health Care
Population Surveillance
Private Sector
Qualitative Research
Young Adult

Source:
Malar J. 18
Pubmed ID:
31806025
Pubmed Central ID:
PMC6896765
Document Type:
Journal Article
Funding:
OPP1089413/Bill and Melinda Gates Foundation/
Place as Subject:
Haiti ; Dominican Republic
Haiti ; Dominican Republic Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:fb20ecca79c54fe883a1a682b35bb04d9f0ee627acff901a8fd1487faa44cc6a
File Type:

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