Strengthening Malaria Service Delivery through Supportive Supervision and Community Mobilization in an Endemic Indian Setting : An Evaluation of Nested Delivery Models
Malaria continues to be a prominent global public health challenge, in part because of the slow population adoption of recommended preventive and curative behaviors. This paper tests the effectiveness of two service delivery models designed to prom...
| Main Authors: | , , , , , , |
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2014
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2014/05/19611110/strengthening-malaria-service-delivery-through-supportive-supervision-community-mobilization-endemic-indian-setting-evaluation-nested-delivery-models-strengthening-malaria-service-delivery-through-supportive-supervision-community-mobilization-endemic-indian-setting-evaluation-nested-delivery-models http://hdl.handle.net/10986/18785 |
| Summary: | Malaria continues to be a prominent
global public health challenge, in part because of the slow
population adoption of recommended preventive and curative
behaviors. This paper tests the effectiveness of two service
delivery models designed to promote recommended behaviors,
including prompt treatment seeking for febrile illness, in
Odisha India. The tested modules include supportive
supervision of community health workers and community
mobilization promoting appropriate health seeking. Program
effects were identified through a randomized cluster trial
comprising 120 villages from two purposively chosen
malaria-endemic districts. Significant improvements were
measured in the reported utilization of bed nets in both
intervention arms vis-à-vis the control. Although overall
rates of treatment seeking were equal across the study arms,
treatment seeking from community health workers was higher
in both intervention arms and care seeking from trained
providers also increased with a substitution away from
untrained providers. Further, fever cases in both treatments
were more likely to have received timely medical treatment
(within 24 hours) from a skilled provider. The study arm
with supportive supervision was particularly effective in
shifting care seeking to community health workers and
ensuring prompt diagnosis and treatment. A community-based
intervention combining the supportive supervision of
community health workers with intensive community
mobilization can be effective in shifting care seeking and
increasing preventive behavior, and thus may be used to
strengthen the national malaria control program. |
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