Abstract
Nigeria's 2009–2013 malaria strategic plan adopted WHO diagnosis and treatment guidelines, which include the use of rapid diagnostic tests (RDTs) prior to prescribing treatment with artemisinin combination therapies (ACTs). The current study explores accessibility barriers to the use of RDTs in Niger State and makes recommendations for improving the uptake of RDTs. The study employs literature review, review of data from the Niger State Health Management Information System for January–October 2013, and application of Peters' conceptual framework for assessing access to health services. Data showed that 27 percent of public health facilities (HFs) implemented RDTs, with the aid of donor funds. In these facilities, 77 percent of fever cases presented during the study period were tested with RDTs; 53 percent of fever cases were confirmed cases of malaria, while 60 percent of fever cases were treated. Stockouts of RDTs were a major constraint, and severe fever tended to trigger presumptive treatment. We conclude that although implementation of RDTs led to a reduction in the use of ACTs at HFs, more substantial reduction could be achieved if the state government directed more resources towards the acquisition of RDTs as well as raising the level of awareness of potential users.
Highlights
We present Health Management Information System (HMIS) data that quantifies the quality of care of malaria patients at the 375 supported health facilities (HFs) in Niger State from January to October 2013
To have the state free of malaria by year 2020 as enshrined in the state governor’s “Niger State Vision 3:2020” [64], concerted efforts and commitment will be required by the state government
Parasitological confirmation of malaria has been officially adopted by Niger State, after almost half a decade the Niger State government still has not procured rapid diagnostic tests (RDTs)
Summary
Niger State (see Figure 1) is a state in the North Central Nigeria, covering a total land mass of 76,363 Km2 (about 10% of Nigeria’s total land mass) and possessing an estimated population of 4,372,030 people (2,215,824 males and 2,156,206 females) [1]. It is the largest among the 36 states and the Federal Capital territory (FCT) of Nigeria and comprises 25 local government areas (LGAs). The state was recognized by The Global Fund (GF) in 2012 for malaria Round 8 implementation efforts.
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