Private Sector Engagement in the

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					   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
      Access to health facilities to rural populations                     Opportunity to Reach
                                                                           Over 10,000 private
100                                                                        pharmacies in Nepal

                                                                           About 40% in rural
60                                                                         VDCs

                                                                           Population coverage
20                                                                         per retail outlet :
                                                                           5,360 in rural VDCs
      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

                                    Design and
                                 implementation of
                                   target group
        Engagement of Private Sector Health

•   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

• Conducted training of private
  sector health service providers
  (drug retailers) and Female
  Community Health Volunteers
  (FCHVs) in coordination with
  the District Public Health
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.
• 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


                                    Avg. marks scored by the participants (FM 15)
• Improved knowledge of                                                             10

  malaria prevention and                                                             8

  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

• 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.
• 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.