Lessons learned in Home Management of Malaria
Implementation research in four African countries
Summary
Studies on treatment-seeking behaviour have shown that most malaria episodes are first treated at home using shop-bought drugs. Part of the reason for this is poor access to, and the perceived poor performance of, the formal health services. These treatments are usually incorrect or suboptimal. Since the majority of children who die from malaria do so within 48 hours of onset of illness, the early use of effective antimalaria medicines close to the home can help to reduce the burden of the disease in sub-Saharan Africa and minimize the life-threatening consequences of treatment delays.
As a result of these studies, HMM has become a cornerstone of malaria case-management and, more generally, of malaria control in sub-Saharan Africa. Many countries have incorporated HMM in their strategic plans to roll back malaria, or in their successful applications to the Global Fund to fight AIDS, Tuberculosis and Malaria, and are now moving to large-scale implementation of HMM.
This guide focuses in particular on four countries – Burkina Faso, Ghana, Nigeria and Uganda – where country teams have completed community-based studies on HMM, assessing its operational feasibility, acceptability and (in Burkina Faso) impact on severe disease.