Evidence for Malaria Medicines Policy ACTwatch Study Reference Document The Republic of Zambia Outlet Survey 2014 www.ACTwatch.info Copyright © Population Services International (PSI). All rights reserved. Released May 2015 Suggested citation ACTwatch Group and SFH. (2015). ACTwatch Study Reference Document: The Republic of Zambia Outlet Survey 2014. Washington DC: PSI. Contact Dr. Megan Littrell Dr. Namwinga Chintu ACTwatch Principal Investigator Principal Investigator – Population Services International PSI | 1120 19th St NW Suit 600 (SFH/PSI) Zambia Washington DC 20036 Plot # 549, Ituna Road, Ridgeway Lusaka, Zambia [email protected] [email protected] Acknowledgements ACTwatch is funded by the Bill and Melinda Gates Foundation, UNITAID, and the UK Department for International Development. This study was implemented by Population Services International (PSI). Society for Family Health Field Supervisors – Zambia Field Team Members Dr. Mutinta Nalubamba Alex Mwilenga Abraham Kaoma Nyongwe Lason Kapata Benny Mubanga Abraham Silwenga Christopher Mbinji Clymore Kalyangile Carol Tracy Matanda Carlos Muleya Derrick Bweupe Catherine Musonda Mwape Lupiya Chilambwe Gift Daka Clive Banda Glenda Chileshe Mumba Cosmas Phiri Ministry of Health Justin Mukupa Daisy Mulenga Chitalu Dr. Kamuliwo Mulakwa Lillian Mambwe Duntu M. Malyenkuku Marksman Foloko Emma Nyirenda ACTwatch Team Mufaya Lindunda Emmanuel Kema Kapandula Andrew Andrada Mukenji Nyembo Enock Mwila Erick Auko Patricia Sakala Febian Mubuyaeta Dr. Hana Bilak Sombo Samuyachi Francis Kaluba Bweupe Dr. Desmond Chavasse Stephen Busiku Hellen Mtonga Kevin Duff Sydney Ticklay Choombe Mulawo Isaac Jere Gloria Kigo Victor Miyanda Jackson Chikampa Makai Tarryn Haslam Jameson Kaunda Dr. Megan Littrell Martin Nsakanya Julius Ngigi Maurice Manyando Ricki Orford Mawana Jere Stephen Poyer Mercy Kumbwa Dr. Justin Rahariniaina Milner Koni Raymond Sudoi Mubanga Bweupe Musekwa Siloka Nancy Mwale Packsivia Sifumbe Pamela Mweene Patrick Chansa Paul K. Mufwaya Peter Mulunda Ruth Mwitwa Sakanya Shimeo Samuel Kapandula Sara Nkhoma Steward Mantanga Wamulume Mumbuna Womba Banda www.ACTwatch.info Page 1 Table of Contents List of Tables ...................................................................................................................................................... 3 List of Figures ..................................................................................................................................................... 5 Definitions .......................................................................................................................................................... 8 Introduction ..................................................................................................................................................... 10 Summary of Methods and Data Collection ...................................................................................................... 11 Summary of Key Findings ................................................................................................................................. 13 Results Results Section A: Core Indicators ................................................................................................................... 34 Results Section B: Core Indicators across Urban/Rural Location .................................................................... 50 Results Section C: Core iIndicators by Type of Public Health Facility .............................................................. 74 Results Section D: Core Indicators across Survey Round: 2010, 2011, 2014 .................................................. 78 Annexes Annex 1: ACTwatch Background ...................................................................................................................... 94 Annex 2: Country Background ......................................................................................................................... 97 Annex 3: Outlet Survey Methods ................................................................................................................... 101 Annex 4: Sampled Wards ............................................................................................................................... 105 Annex 5: Detailed Sample Description .......................................................................................................... 106 Annex 6: Questionnaire ................................................................................................................................. 108 Annex 7: Antimalarial Reference ................................................................................................................... 128 Annex 8: RDT Reference ................................................................................................................................ 132 Annex 9. Sampling Weights ........................................................................................................................... 134 Annex 10: Indicator Definitions ..................................................................................................................... 136 Annex 11. Adult Equivalent Treatment Dose (AETD) .................................................................................... 144 Annex 12: Antimalarial Volumes.................................................................................................................... 146 www.ACTwatch.info Page 2 List of Tables Core Indicators Table S1: Key results, by outlet type - 2014 .................................................................................................................... 13 Table A1: Availability of antimalarials, among all screened outlets, by outlet type ....................................................... 34 Table A2: Availability of antimalarials, among outlets stocking at least one antimalarial, by outlet type ..................... 36 Table A3: Antimalarial market composition ................................................................................................................... 38 Table A4a: Price of tablet formulation antimalarials, by outlet type ............................................................................. 39 Table A4b: Price of pre-packaged antimalarials, by outlet type ..................................................................................... 40 Table A5: Availability of malaria blood testing among antimalarial-stocking outlets*, by outlet type .......................... 41 Table A6: Malaria blood testing market composition .................................................................................................... 42 Table A7: Price of malaria blood testing, by outlet type ................................................................................................ 43 Table A8: Antimalarial market share .............................................................................................................................. 44 Table A9: Antimalarial market share across outlet type ................................................................................................ 45 Table A10: Malaria blood testing market share ............................................................................................................. 46 Table A11: Malaria blood testing market share, across outlet type ............................................................................... 47 Table A12: Provider case management knowledge and practices, by outlet type ......................................................... 48 Table A13: Provider antimalarial treatment knowledge and practices, by outlet type ................................................. 49 Table B1: Availability of antimalarials, among all screened outlets, by outlet type, across urban/rural location ......... 50 Table B2: Availability of antimalarials, among all outlets stocking at least one antimalarial, by outlet type, across urban/rural location ........................................................................................................................................ 55 Table B3: Antimalarial market composition, across urban/rural location ...................................................................... 59 Table B4a: Price of tablet formulation antimalarials, by outlet type, across urban/rural location ................................ 60 Table B4b: Price of pre-packaged antimalarials, by outlet type, across urban/rural location ....................................... 62 Table B5: Availability of malaria blood testing among antimalarial-stocking outlets*, by outlet type, across urban/rural location ........................................................................................................................................ 63 Table B7: Price of malaria blood testing, by outlet type, across urban/rural location ................................................... 64 Table B8.1: Antimalarial market share, urban ................................................................................................................ 66 Table B8.2: Antimalarial market share, rural .................................................................................................................. 67 Table B9.1: Antimalarial market share across outlets, urban ......................................................................................... 68 Table B9.2: Antimalarial market share across outlets,