The Health Zone Warehouse Manager in Abomey-Calavi/SoVa poses with ACTs. Photo credit: ARM3/MCDI.
The private sector is a major source of health care in Benin and PMI is active in positioning the private sector to play a greater role in improving universal access to affordable, quality malaria care. PMI recently supported a private sector assessment to identify options for the delivery of malaria commodities to private health facilities. While the assessment focused specifically on delivery of artemisinin-based combination therapy (ACTs) and Rapid Diagnostic Tests (RDTs), the results recommended that registered private sector health facilities get access to all subsidized malaria commodities, including those delivered through antenatal care.
Results of the private sector assessment were published and the recommendations led to a joint proposition by the Ministry of Health (MOH) and partner stakeholders of a validated approach that gives registered private sector health facilities access to subsidized malaria commodities. This access is based on specific predefined conditions such as (i) compliance with the selling price of ACTs in the public sector, (ii) free RDTs, (iii) commitment to comply with related policies, strategies, guidelines, and protocols for malaria management, and (iv) commitment to be regularly supervised and evaluated by the National Malaria Control Program (NMCP).
In 2017, PMI piloted this new approach with 122 registered private clinics in four health districts across the country. A total of 41 private clinics are submitting monthly reports to the health district warehouses. Participation of private clinics in this scheme is expected to reduce the out of pocket cost of malaria case management and improve the accuracy of routine malaria data and quantification of commodities.
According to information collected during the first post-training supervision visits, the participation of private health facilities in accessing malaria commodities is mixed – ranging from 100 percent of the 25 health facilities in one district to 52 percent of the 17 health facilities in another district. Case management records indicate that over 13,960 RDTs have been administered since the training.
This pilot has shown that the private sector clinics are willing to be involved and actively participate in the fight against malaria in Benin. Furthermore, they have expressed their willingness to comply with the conditions required by the NMCP to access the subsidized malaria commodities. It is also necessary to strengthen post-training supervision and ensure that national quantification of malaria requirements includes private sector consumption data.
As a result of this experience, Benin intends to scale-up this model to other health zones as well as extend training on logistics reporting and commodity management to private sector staff.