The National Malaria Center has targeted private clinics and pharmacies in an effort to improve the consistency and quality of malaria treatment in Cambodia.
“Right now, you could walk into any private clinic and find that they are not adhering to malaria guidelines,” said Seshu Babu, a consultant to the Ministry of Health’s National Malaria Center.
Currently, there is no comprehensive system to keep track of malaria treatment in Cambodia. Health studies are instead limited to public hospitals and clinics, Babu said.
The survey, which took place between July and December of last year, focuses on private health facilities in provinces known for high rates of malaria and drug resistance. Nearly 200 providers from Kampot, Pursat and Stung Treng provinces and Pailin municipality received malaria education, national treatment guidelines and subsidized drugs, he said.
In return, participants reported new cases and methods of treatment to the Ministry of Health. This information will be combined with public health records to create a clearer image of malaria in Cambodia.
“We hope that patients going to treatment in the private sector will receive quality care,” said Babu, adding that the project aims to improve and regulate quality of care in private facilities.
The study, led by the Ministry of Health and the Society for Malaria Control in Cambodia, was conducted as a pilot program. Along with the support of Canadian International Development Agency and Population Service International, the program could expand to 1,299 private providers in 12 provinces, if funding is approved.
Eighty percent of malaria cases in Cambodia are treated in private care where most patients do not receive up-to-date treatment. This has led to increased resistance to drugs, Babu said.
“Private providers speak the people’s language, they are respected,” said Babu, “but they use substandard drugs and sometimes lack training.”
Roughly 500,000 Cambodians live in forested areas with high transmission rates, according to the World Health Organization. Infection is as high as 40 percent in some forested areas. Soldiers, forestry workers and gem miners are most at risk of acquiring the disease.
Not surprisingly, of the 9,356 cases identified in the survey, 80 percent also worked in forest-related occupations, and at least two-thirds were men. Still, Babu points out that for villages that are located within forests, rates of infection are the same among men, women and children.
Since last year, Babu says that quality of treatment appears to have improved in participating providers.
“These people have been handling the malaria cases relatively decently,” he said.