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Myanmar 2015 Reference Document Evidence for Malaria Medicines Policy ACTwatch Study Reference Document The Republic of the Union of Myanmar 2015 www.ACTwatch.info Released November 2016 Suggested citation ACTwatch Group and Population Services International Myanmar (PSI MM). (2016). ACTwatch Study Reference Document: Myanmar Outlet Survey 2015. Washington DC: PSI. Contact Dr. Megan Littrell Dr. Si Thu Thein Dr. Hnin Su Su Khin ACTwatch Principal Investigator PSI/Myanmar, Deputy Director of PSI/Myanmar, Director of Malaria Programs PSI | 1120 19th St NW Suite 600 Strategic Information 16 West Shwe Gone Dine 4th St Washington DC 20036 16 West Shwe Gone Dine 4th St Bahan Township, Yangon, Myanmar [email protected] Bahan Township, Yangon, Myanmar Phone: +951 375 854 Phone: +951 375 854 Fax: +951 527 668 Fax: +951 527 668 Email: [email protected] Email: [email protected] Acknowledgements This study was jointly conducted under the ACTwatch Program, funded by the Bill and Melinda Gates Foundation and the PSI Myanmar Artemisinin Monotherapy Replacement Project (AMTR), funded by the Bill and Melinda Gates Foundation, the UK Department for International Development, and Good Ventures. This study was implemented by Population Services International (PSI). PSI Myanmar PSI Myanmar Field Team Myanmar Survey Research Dr. Si Thu Thein Ye Kyaw Aung Patrick Meza Hein Ko Ko Htet Dr. Hnin Su Su Khin Eh Thi Paw Sanyu Aung Bwai Htan Lyan Dr. Tin Aung Sandar Oo Paing Swan Khaing Zaw Zaw Pyae Sone Barry Whittle Dr. Ei Ei Khaing Nay Min Thu Kyaw Zeya Leah Valencia Dr. Nan Yu Wai Min Aung Su Nandar Hlaing Daniel Crapper Dr. Aung Min Htut Chit Ko Lwin Thein Than Tun Saw Win Aye Myat Mon Wai Yan Ko Ko ACTwatch Team Hlaing Myint Tun Ant Min Nyo Tin Tin Aye Andrew Andrada Thet Swe Khin Zaw Yan Naing Aung Erick Auko Nay Lin Tun Thura Win May Thazin Oo Dr. Katie Bates Zaw Min Htet Bo Than Htike Soe Nyi Nyi Lwin Dr. Paul Bouanchaud Lel Pwe Htoo Hnin Thandar Bo Kyaw Naing Htwe Dr. Desmond Chavasse Kyaw Soe Linn Thet Thet Robyn Cyr Chit Oo Maung Tun Tun Win Kevin Duff Haymar Zin Myint Thazin Tin Win Keith Esch Hein Ko Ko Thant Than Myat Soe Anna Fulton Yu Hlaing Hnin Htet Arkar Kyaw Tarryn Haslam Toe Toe Catherine Hurley Whitney Isenhower Focus Point Research Services Co., LTD. Dr. Beth Kangwana May Khalar Win Daw Marlar Khine U Thein Htike Aung Gloria Kigo Daw Soe Ei San U Tin Lin Aung U Kaung Htet Aliza Lailari U Myo Zaw Nyein U Kaday Kyaw U Htet Naing Win Dr. Megan Littrell Daw Nant Aye Aye Than Daw Tun Ei Ei Aung Daw Aye Myo Myo Win Julius Ngigi U San Lin Soe U Aye Min Zaw Daw Lwin Mar Thant Dr. Kathryn O’Connell Daw Khin Sandar Htun U Soe Min Than Daw Aye Aye Maw Ricki Orford U Tun Yar Zar Kyaw U Aung Zaw Win U Ye Ko Ko Stephen Poyer Daw Thin Thin Hlaing U Ko Ko Paing U Than Aung Htay Dr. Justin Rahariniaina Daw Yin Yin Nu U Kyi Zin Ko U Pyae Phyo Christina Riley Daw Cho Lin Hlaing U Ye Htet Aung U Aung Soe Moe Dr. Andria Rusk U Min Nyan Htet Aung U Hein Min Htun U Zam Zo Taung Julianna Smith U Tin Tun Naing U Pyae Thu Naing U Kyaw Min Thu Rachel Thompson U Zay Yar Aung U Htun Naung Naung Oo Daw Pan Ei Phyu Cynthia Whitman Daw Kyi Pyar Win U Kyaw Thet Khine U Win Htun www.ACTwatch.info Page 1 Table of Contents LIST OF TABLES ................................................................................................................................................... 3 LIST OF FIGURES ................................................................................................................................................. 5 LIST OF ABBREVIATION ...................................................................................................................................... 9 DEFINITIONS ..................................................................................................................................................... 10 INTRODUCTION ................................................................................................................................................ 12 SUMMARY OF METHODS AND DATA COLLECTION ......................................................................................... 14 SUMMARY OF KEY FINDINGS ........................................................................................................................... 17 RESULTS SECTION A: CORE INDICATOR NATIONAL ESTIMATES ...................................................................... 77 RESULTS SECTION B: CORE INDICATORS ACROSS DOMAINS........................................................................... 96 RESULTS SECTION C: ORAL ARTEMISININ MONOTHERAPY INDICATOR NATIONAL ESTIMATES ................... 150 RESULTS SECTION D: ORAL ARTEMISININ MONOTHERAPY INDICATORS ACROSS DOMAINS ...................... 155 ANNEX 1: ACTWATCH BACKGROUND ............................................................................................................ 172 ANNEX 2: COUNTRY BACKGROUND............................................................................................................... 175 ANNEX 3: ARTEMISININ MONOTHERAPY REPLACEMENT PROJECT .............................................................. 183 ANNEX 4: OUTLET SURVEY METHODS ........................................................................................................... 184 ANNEX 5: SAMPLED TOWNSHIPS .................................................................................................................. 187 ANNEX 6: DETAILED SAMPLE DESCRIPTION .................................................................................................. 189 ANNEX 7: QUESTIONNAIRE ............................................................................................................................ 191 ANNEX 8: ANTIMALARIAL PRODUCT INFORMATION .................................................................................... 221 ANNEX 9: RDT REFERENCE ............................................................................................................................. 226 ANNEX 10. SAMPLING WEIGHTS ................................................................................................................... 227 ANNEX 11: INDICATOR DEFINITIONS ............................................................................................................. 228 ANNEX 12. ADULT EQUIVALENT TREATMENT DOSE (AETD) ......................................................................... 242 www.ACTwatch.info Page 2 List of Tables Summary of Key Findings Table S1: Key results, by outlet type ............................................................................................................................... 17 Table S2: Key results, by outlet type, across domain ..................................................................................................... 20 Results Section A: Core Indicator National Estimates Table A1: Availability of antimalarials, among all screened outlets, by outlet type ....................................................... 77 Table A2: Availability of antimalarials, among antimalarial-stocking outlets, by outlet type ........................................ 79 Table A3: Provision of malaria blood testing and antimalarials in the past week, among outlets with testing/antimalarials available, by outlet type ....................................................................................................... 81 Table A4: Types of quality-assured and non-quality-assured ACTs audited in the public and private sector ............... 83 Table A5: Antimalarial market composition ................................................................................................................... 84 Table A6a: Price of tablet formulation antimalarials, by outlet type ............................................................................. 85 Table A6b: Price of pre-packaged antimalarials, by outlet type ..................................................................................... 86 Table A7: Availability of malaria blood testing among antimalarial-stocking outlets*, by outlet type .......................... 87 Table A8: Malaria blood testing market composition .................................................................................................... 88 Table A9: Price of malaria blood testing for adults, by outlet type ................................................................................ 89 Table A10: Antimalarial market share ............................................................................................................................ 90 Table A11: Antimalarial market share within outlet type .............................................................................................. 91 Table A12: Malaria blood testing market share ............................................................................................................. 92 Table A13: Malaria blood testing market share, across outlet type ............................................................................... 93 Table A14: Private sector case management training, supervision, support and surveillance, by outlet type ............. 94 Table A15: Provider antimalarial treatment knowledge and practices, by outlet type ................................................. 95 Results Section B: Core Indicators Across Domains Table B1: Availability of antimalarials, among all screened outlets, by outlet type, across domain ............................. 96 Table B2: Availability of antimalarials, among antimalarial-stocking
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