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. 2007 Jun 29:6:83.
doi: 10.1186/1475-2875-6-83.

Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

Manuel W Hetzel  1 , Nelly Iteba, Ahmed Makemba, Christopher Mshana, Christian Lengeler, Brigit Obrist, Alexander Schulze, Rose Nathan, Angel Dillip, Sandra Alba, Iddy Mayumana, Rashid A Khatib, Joseph D Njau, Hassan Mshinda
Affiliations

Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

Manuel W Hetzel et al. Malar J. .

Abstract

Background: Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately.

Project: The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services.

Conclusion: The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.

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Figures

Figure 1
Figure 1
Map of Kilombero and Ulanga districts with DSS area.
Figure 2
Figure 2
Timeline with main interventions and M&E activities.
Figure 3
Figure 3
ACCESS road show with social marketing truck.
Figure 4
Figure 4
ACCESS billboard promoting prompt and correct treatment.
Figure 5
Figure 5
ACCESS Programme logo.
Figure 6
Figure 6
Map of the study area showing intervention areas 2004 – 2006.
Figure 7
Figure 7
Coverage of social marketing campaign in 25 DSS villages: proportion of the population that has attended an ACCESS road show by age group.
Figure 8
Figure 8
Average monthly out-patients attendance at 16 health facilities in the DSS and Ifakara in 2004 (ARI = Acute Respiratory Infections).
See this image and copyright information in PMC

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