Has Tanzania Embraced the Green Leaf? Results from Outlet and Household Surveys before and after Implementation of the Affordable Medicines Facility -Malaria

摘要: Background The Affordable Medicines Facility - malaria (AMFm) is primarily an artemisinin combination therapy (ACT) subsidy, aimed at increasing availability, affordability, market share and use of quality-assured ACTs (QAACTs). Mainland Tanzania was one eight national scale programmes where AMFm introduced in 2010. Here we present findings from outlet household surveys before after implementation to evaluate its impact both the supply demand side. Methods Outlet were conducted 49 randomly selected wards throughout mainland 2010 2011, data on characteristics stocking patterns collected outlets antimalarials. Household 240 enumeration areas three regions 2012. Questions about treatment seeking for fever drugs obtained asked individuals reporting previous two weeks. Results availability QAACTs increased 25.5% 69.5% among all types, with greatest increase pharmacies drug stores, together termed specialised sellers (SDSs), median QAACT price fell $5.63 $0.94. The 26.2% 42.2%, again SDSs. survey results showed a shift away public sector towards Overall, there no change proportion people obtaining antimalarial or ACT baseline endline. However, when broken down by source, significantly clients visiting SDSs. Discussion Unchanged overall, despite increases affordability private sector, reflected providers. reasons this are unclear, but likely reflect persistent stockouts facilities, subsidised sector.