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Impact of Ministry of Health Interventions on Private Medicine Retailer Knowledge and Practices on Anti-Malarial Treatment in Kenya

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  • 1 Kenya Medical Research Institute/Wellcome Trust Centre for Geographic Medicine Research-Coast, Kilifi, Kenya; Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; Ministry of Health, Kilifi District Hospital, Kilifi, Kenya; Provincial Medical Officer, Nairobi Province, Kenya; World Vision Kenya, Nairobi, Kenya; Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), University of Oxford, Headington, Oxford, United Kingdom

Small-scale interventions on training medicine retailers on malaria treatment improve over-the-counter medicine use, but there is little evidence on effectiveness when scaled up. This study evaluated the impact of Ministry of Health (MoH) training programs on the knowledge and practices of medicine retailers in three districts in Kenya. A cluster randomized trial was planned across 10 administrative divisions. Findings indicated that 30.7% (95% confidence interval [CI]: 23.3, 39.0) and 5.2% (95% CI: 2.1, 10.3) of program and control retailers, respectively, sold MoH amodiaquine with correct advice on use to surrogate clients (OR = 8.8; 95% CI: 2.9, 26.9; P < 0.001). Similarly, 61.8% (95% CI: 54.2, 69.1) and 6.3% (95% CI: 2.7, 12.1) of program and control retailers, respectively, reported correct knowledge on dosing with amodiaquine (OR = 29.8; 95% CI: 8.2, 108.8). Large-scale retailer training programs within the national malaria control framework led to significant improvements in retailers’ practices across three districts.

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