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 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.

Bibliographic Details

Main Authors:	Das, Ashis, Friedman, Jed, Kandpal, Eeshani, Ramana, GNV, Das Gupta, R K, Pradhan, Madan M, Govindaraj, Ramesh
Format:	Policy Research Working Paper biblioteca
Language:	English en_US
Published:	World Bank, Washington, DC 2014-06
Subjects:	ACCESS TO TREATMENT, ANTIMALARIAL DRUGS, BACK MALARIA, BEHAVIOR CHANGE, BIRTH OUTCOMES, CAPACITY BUILDING, CARE PROVIDERS, CARE SEEKING, CASE MANAGEMENT, CHILDBEARING, COMMUNICATION CHANNELS, COMMUNITIES, COMMUNITY HEALTH, COMMUNITY HEALTH CARE, COMMUNITY HEALTH WORKERS, COMMUNITY INVOLVEMENT, COMMUNITY MOBILIZATION, COMMUNITY PARTICIPATION, COST EFFECTIVENESS, CS, DEPRESSION, DEVELOPMENT POLICY, DIAGNOSIS, DIAGNOSTIC TESTS, DISEASE, DISEASE BURDEN, DISEASE CONTROL, DISEASE TRANSMISSION, DISEASES, DISSEMINATION, DISTRICTS, DRUG USERS, EARLY DETECTION, ECONOMIC STATUS, EQUALITY, EXERCISES, FAMILY WELFARE, FEBRILE ILLNESS, FEMALE, FEMALES, FEVER, FORMAL EDUCATION, HEALTH ACTIVISTS, HEALTH BEHAVIOR, HEALTH CENTERS, HEALTH CONDITIONS, HEALTH FACILITIES, HEALTH FACILITY, HEALTH INTERVENTIONS, HEALTH MANAGEMENT, HEALTH NEEDS, HEALTH POLICY, HEALTH SECTOR, HEALTH SEEKING, HEALTH SERVICES, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH WORKERS, HOUSEHOLD LEVEL, HOUSEHOLD SIZE, HOUSEHOLD SURVEYS, HOUSEHOLDS, ILLNESSES, IMMUNIZATION, INHABITANTS, INTERVENTION, KINSHIP, LOCAL CAPACITY, LOCAL COMMUNITY, MALARIA, MALARIA BURDEN, MALARIA CASES, MALARIA CONTROL, MALARIA IN PREGNANCY, MALARIA MORBIDITY, MALARIA REPORT, MALARIA TREATMENT, MEDICAL RESEARCH, MEDICAL TREATMENT, MEDICINES, MINISTRY OF HEALTH, MORBIDITY, MORBIDITY AND MORTALITY, MORTALITY, NEWBORN, NEWBORN HEALTH, NURSES, ONCHOCERCIASIS, ONCHOCERCIASIS CONTROL, PERIPHERAL HEALTH FACILITIES, PNEUMONIA, POLICY DISCUSSIONS, POLICY IMPLICATIONS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POPULATION INFORMATION, POSTERS, PREGNANCY, PREGNANT WOMEN, PREVALENCE, PREVENTION ACTIVITIES, PREVENTION OF MALARIA, PRIMARY EDUCATION, PRIMARY HEALTH CARE, PRIMARY SCHOOL, PROGRESS, PUBLIC HEALTH, PUBLIC SERVICE, QUALITY ASSURANCE, QUALITY IMPROVEMENT, RELIGIOUS GROUPS, REPRODUCTIVE AGE, RURAL AREAS, RURAL COMMUNITIES, RURAL DISTRICT, SANITATION, SCHOOLS, SELF HELP, SERVICE DELIVERY, SERVICE DELIVERY MODELS, SEX, SEX WORKERS, SLEEP, SOCIAL NORMS, SPONSORS, SYMPTOMS, THERAPY, TRADITIONAL MEDIA, TREATMENT OF MALARIA, VILLAGE LEVEL, VILLAGES, VULNERABLE POPULATIONS, WOMEN OF CHILDBEARING AGE, WORKERS, WORLD HEALTH ORGANIZATION, YOUNG CHILDREN, YOUTH, YOUTH CLUBS,
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
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