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An assessment of the availability of medicines and other supplies in the Lake Zone, Tanzania
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Annually, almost ten million under five children die due to febrile illnesses in the world (Jones, et al., 2003). Tanzania is among six countries with the leading malaria morbidity and mortality rates in the world (WHO, 2012). The Government of Tanzania has put in place initiatives designed to improve febrile illnesses case management, and a number of interventions that have been designed through adopting and rolling out integrated management of childhood illness (IMCI). To add to the government’s efforts to reduce morbidity and mortality rates related to febrile illnesses, the United States Agency for International Development (USAID) funded the Tibu Homa Project (THP) with the goal of reducing morbidity and mortality among children under five years due to febrile illnesses in the Lake Zone of Tanzania (Kagera, Mara, Mwanza, Geita, Shinyanga, and Simiyu regions). The Tibu Homa Project is implemented by the University Research Co., LLC (URC) in collaboration with Management Sciences for Health (MSH) and Amref Health Africa.
A baseline assessment carried out in January 2012 showed that only 11% of public facilities and 32% of private facilities had artemisinin-based combination therapies (ACTs) in stock and had not experienced stock-outs in the previous seven days. By June 2012, the proportion of facilities that had ACTs in stock rose to 75% in private facilities and 83% in public facilities. Based on the above findings, Tibu Homa set out to investigate the causes that may have contributed to the noted improvements. Similarly, some stakeholders and partners believed that these improvements were due to the project’s interventions, while others noted the results were due to system-wide strengthening of the medicine supply chain in the country.
To test the hypothesis that improvements in the availability of medicines and diagnostics in the Lake Zone were due to the project’s interventions, Tibu Homa compared data from facilities that received Tibu Homa support with a control group of facilities that had been identified for intervention but had not yet been reached.
The team looked at the patient records of 3,169 children under five years of age: 1,632 in facilities that had received the projects intervention, and 1,537 in the controlled facilities who were presented with fever in the four weeks prior to the survey. Data showed a significantly higher proportion of children that were treated within 24 hours after the onset of fever in the intervention facilities compared to those treated in the control facilities. Similarly, more children were tested for malaria in the intervention facilities than the control facilities.
Study findings also indicated that the availability of febrile illness medicines and supplies was better in facilities supported by Tibu Homa compared to those not supported by the project. Intervention facilities were 4.5 times more likely than those in the control group to have five or more key febrile-illness related medicines in stock on the day of the visit and were 2.9 times more likely than those in the control group to have 10 or more tracer medicines available. Therefore, this study has demonstrated that the project’s interventions have improved availability of medicines and supplies in the supported facilities in the Lake Zone regions of Tanzania.