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dc.contributor.author Smith, N
dc.contributor.author Obala, A
dc.contributor.author Simiyu, C
dc.contributor.author Menya, D
dc.contributor.author Khwa-Otsyula, B
dc.contributor.author O'Meara, WP
dc.coverage.spatial England
dc.date.accessioned 2012-10-30T17:28:34Z
dc.date.issued 2011-10-26
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/22029829
dc.identifier 1475-2875-10-316
dc.identifier.citation Malar J, 2011, 10 pp. 316 - ?
dc.identifier.uri http://hdl.handle.net/10161/5946
dc.description.abstract BACKGROUND: Poor access to prompt and effective treatment for malaria contributes to high mortality and severe morbidity. In Kenya, it is estimated that only 12% of children receive anti-malarials for their fever within 24 hours. The first point of care for many fevers is a local medicine retailer, such as a pharmacy or chemist. The role of the medicine retailer as an important distribution point for malaria medicines has been recognized and several different strategies have been used to improve the services that these retailers provide. Despite these efforts, many mothers still purchase ineffective drugs because they are less expensive than effective artemisinin combination therapy (ACT). One strategy that is being piloted in several countries is an international subsidy targeted at anti-malarials supplied through the retail sector. The goal of this strategy is to make ACT as affordable as ineffective alternatives. The programme, called the Affordable Medicines Facility - malaria was rolled out in Kenya in August 2010. METHODS: In December 2010, the affordability and accessibility of malaria medicines in a rural district in Kenya were evaluated using a complete census of all public and private facilities, chemists, pharmacists, and other malaria medicine retailers within the Webuye Demographic Surveillance Area. Availability, types, and prices of anti-malarials were assessed. There are 13 public or mission facilities and 97 medicine retailers (registered and unregistered). RESULTS: The average distance from a home to the nearest public health facility is 2 km, but the average distance to the nearest medicine retailer is half that. Quinine is the most frequently stocked anti-malarial (61% of retailers). More medicine retailers stocked sulphadoxine-pyramethamine (SP; 57%) than ACT (44%). Eleven percent of retailers stocked AMFm subsidized artemether-lumefantrine (AL). No retailers had chloroquine in stock and only five were selling artemisinin monotherapy. The mean price of any brand of AL, the recommended first-line drug in Kenya, was $2.7 USD. Brands purchased under the AMFm programme cost 40% less than non-AMFm brands. Artemisinin monotherapies cost on average more than twice as much as AMFm-brand AL. SP cost only $0.5, a fraction of the price of ACT. CONCLUSIONS: AMFm-subsidized anti-malarials are considerably less expensive than unsubsidized AL, but the price difference between effective and ineffective therapies is still large.
dc.format.extent 316 - ?
dc.language eng
dc.relation.ispartof Malar J
dc.relation.isversionof 10.1186/1475-2875-10-316
dc.subject Antimalarials
dc.subject Artemisinins
dc.subject Drug Combinations
dc.subject Ethanolamines
dc.subject Financing, Government
dc.subject Fluorenes
dc.subject Health Policy
dc.subject Health Services Accessibility
dc.subject Humans
dc.subject Kenya
dc.subject Malaria
dc.subject Pilot Projects
dc.subject Rural Population
dc.title Accessibility, availability and affordability of anti-malarials in a rural district in Kenya after implementation of a national subsidy scheme.
dc.type Journal Article
duke.description.issue 316 en_US
duke.description.volume 10 en_US
dc.relation.journal Malaria Journal en_US
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/22029829
pubs.organisational-group /Duke
pubs.organisational-group /Duke/Institutes and Provost's Academic Units
pubs.organisational-group /Duke/Institutes and Provost's Academic Units/University Institutes and Centers
pubs.organisational-group /Duke/Institutes and Provost's Academic Units/University Institutes and Centers/Global Health Institute
pubs.organisational-group /Duke/School of Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine/Medicine, Infectious Diseases
pubs.publication-status Published online
pubs.volume 10
dc.identifier.eissn 1475-2875

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