Mystery client survey on malaria rapid diagnostic tests Measuring service quality of private outlets.
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Mystery client survey on malaria rapid diagnostic tests
Measuring service quality of private outlets
Study Objective To determine
– the proportion of providers that correctly describe and demonstrate 5 key steps in for conducting and interpreting a rapid diagnostic test for malaria.
– whether provider quality differed by intervention arm and provider type.
The study was conducted 3-5 months after PSI gave RDT training to the target providers
Outlet types
Medical Drug Retailer General retail store
Itinerant Drug Vendor
General Re-tail Stores
63%
Itinerant Drug Vendors
28%
Medical Drug Retailers9%
Intervention DescriptionArm 1: RDT resupply at ~$0.18/RDT, upon receipt of used RDTs
Arm 2: RDT resupply at ~$0.18/RDT, upon receipt of used RDTs Plus: Financial incentive of free RDT test for every 5
RDTs purchased
Arm 3: RDT resupply at ~$0.18/RDT, upon receipt of used RDTs Plus: Bi-weekly support visits to outlets (one-on-one
discussions, BCC/IEC materials, visits to recent patients, etc.)
65% of providers proposed an RDT without prompting.
Of the providers who performed the mRDT, – 95% used an antiseptic– 94% read the results correctly– 85% showed the client results – 84% gave a correct treatment
40% performed all five steps.
Overall findings
WHICH INTERVENTION IS BEST?
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
(n=96) (56.1%)
Provider doesn’t propose blood test (n=57) (33.3%)
Provider proposes blood test at other
facility (n=14) (8.2%)
Arm0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Arm 1Arm 2Arm 3
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
(n=96) (56.1%)
Provider doesn’t propose blood test (n=57) (33.3%)
Provider proposes blood test at other
facility (n=14) (8.2%)
MC asks for Blood Test (n=74) (43.3%)
N=19 ,11.4% additional tests performed after request
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
(n=96) (56.1%)
Provider doesn’t propose blood test (n=57) (33.3%)
Provider proposes blood test at other
facility (n=14) (8.2%)
N=19 ,11.4% additional tests performed after request
Arm0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
Arm 1Arm 2Arm 3
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
(n=96) (56.1%)
Provider doesn’t propose blood test (n=57) (33.3%)
Provider proposes blood test at other
facility (n=14) (8.2%)
MC asks for Blood Test (n=74) (43.3%)
N=19 ,11.4% additional tests performed after request
Arm0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
% of Providers Treating Properly and Reading Result Correctly
Arm 1Arm 2Arm 3
Arm 3: Most likely to treat “not malaria” correctly
WHICH TYPE OF PROVIDER IS BEST?Can you train informal providers to deliver RDTs?
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
Provider doesn’t propose blood test
Provider proposes blood test at other
facility
Type0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
General Retail StoresItinerant Drug VendorsMedical Drug Retailers
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
Provider doesn’t propose blood test
Provider proposes blood test at other
facility
MC asks for Blood Test
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
Provider doesn’t propose blood test
Provider proposes blood test at other
facility
% of Providers Performing Tests
Type55.0%
60.0%
65.0%
70.0%
75.0%
80.0%
General Retail StoresItinerant Drug VendorsMedical Drug Retailers
MC reports fever that s/he suspected of malaria in past week
(n=171)
Provider proposes blood test (RDT) at his/her own facility
Provider doesn’t propose blood test
Provider proposes blood test at other
facility
MC asks for Blood Test
Type0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
% of Providers Treating Properly and Reading Result Correctly
General Retail StoreItinerant Drug VendorMedical Drug Represen-tative
Itinerant Drug Vendors: Most likely to treat “not malaria” correctly
Summary
The quality of providers with regards to performing and interpreting the mRDT was quite high, despite general lack of formal health training among informal private providers.
Providers who received intervention Arm 3 (mRDT subsidies and counseling, education and training) performed the best in regards to correctly treating after using mRDTs.
Among the provider types Itinerant Drug Vendors received the highest percentages in all 5 key steps except for the use of antiseptic.
For almost all 5 key steps General Retail Stores performed better than pharmacies. General Retail Stores are much more numerous than pharmacies in villages.
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