Private Sector Engagement in the Prevention & Control of Malaria in Nepal Empowering Private Sector Health Providers Steven. W Honeyman Population Services International Nepal GFATM Private Sector Partnerships Meeting New Delhi, India December 13, 2007 Private Sector Engagement FILLING THE GAP Access to health facilities to rural populations Opportunity to Reach 120 Over 10,000 private 100 pharmacies in Nepal 80 About 40% in rural 60 VDCs 40 Population coverage 20 per retail outlet : 5,360 in rural VDCs 0 1 hour reach of 1 hour reach of Go to public Go to private a public health a hospital health facilities health facilities facility (65% ) (10% ) (55% ) (35% ) Public-Private-Partnerships for Health Impact in Nepal A Nepal Government National Priority • Public-private partnership initiatives are highlighted within the Government of Nepal’s Health Sector Reform Strategy. • Malaria control and prevention is an intervention area where the government is actively engaging private sector partners in helping to achieve national goals and objectives. • The Government of Nepal and Population Services International (PSI) are working in partnership to implement malaria prevention and control activities in 13 high-risk districts in Nepal. • The program strategy used a creative and innovative project implementation approach which capitalized on the core competencies of the government, the private sector, non- government organizations and civil society. Program Strategy Partnership with NGO & Engagement of private civil society sector health providers Mix of public, social Design & implementation marketing and private Development and of M & E tools and sector partnership implementation of activities to strengthen activities BCC activities partnership and coordination Design and implementation of target group research Engagement of Private Sector Health Providers Objectives: • Establish distribution outlets for social marketing of long lasting insecticide treated nets (LLINs); • Increase public access to trained private sector health providers who have the capacity to quickly detect and effectively treat malaria; • Increase malaria cases referred from private sector health outlets to public health facilities; • Encourage documentation and reporting of malaria cases by private sector health facilities to the government system. Empowering Private Sector Health Providers • Training package “Social Marketing Training for Malaria Prevention & Treatment” was designed for private sector health service providers in coordination with the Epidemiology and Disease Control Division (EDCD), Ministry of Health and Populations. • Conducted training of private sector health service providers (drug retailers) and Female Community Health Volunteers (FCHVs) in coordination with the District Public Health Offices. Empowering Private Sector Health Providers Training objectives • Understand the importance of prevention of malaria especially in pregnant women and under five children. • Develop understanding of social marketing and its importance in the developing country like Nepal. • Develop understanding of malaria, malaria prevention and treatment, usage of long lasting insecticide treated nets (SupaNet) and reporting & documentation. • Practice effective counseling procedures and practices for malaria prevention and malaria prevention message to the community and the referral of confirmed malaria patients to nearby higher-level health facilities. Results • Trained 1,427 private sector health providers in 9 districts (2006-2007). • 44,086 LLINs social marketed through private sector pharmacies. Pre-test vs. Post-test comparison 14 Avg. marks scored by the participants (FM 15) 12 • Improved knowledge of 10 malaria prevention and 8 6 treatment after training. 4 (basis of evaluation of pre and 2 post test questionnaires) 0 Dhanusha Jhapa Morang Bardia Kanchanpur Avg. Pre-test Avg. Post-test Other Potential Roles for the Private Sector in Malaria Control • Increasing the availability of ACT through the private sector. • Working with drug and net manufacturers to provide additional behavior change, use, branding or marketing information on packaging and communications materials. • Improving health seeking behavior (mass media/interpersonal communications). • Combining (public & private) requests for funding. • Improving distribution networks through private sector based on local context. • Partnering in campaign activities and events at the community level. • Growing private sector markets for drugs, diagnostic devices, treatment and LLIN mosquito nets for sustainability. Summary • To be successful, the fight against malaria must harness cross-sectoral capabilities and interests. • The private sector has a major role and contribution in vital scaling-up strategies.