Despite policies that recommend parasitological testing before treatment for malaria, presumptive treatment remains widespread in Nigeria. Poorer individuals seeking care at PPMVs were more likely to receive inappropriate malaria treatment when compared to those who go to pharmacies. Increasing accessibility to reliable diagnosis should be explored to reduce malaria over-treatment.

To reduce the burden of disease from malaria, innovative approaches are needed to engender behavior change. One unobservable, but fundamental trait—preferences for risk—may influence individuals’ willingness to adopt new health technologies. We explore the association of risk preferences with malaria care-seeking behavior and the acceptability of malaria rapid diagnostic tests (RDTs) to inform RDT scale-up plans. Read the publication here.

The World Health Organization now recommends parasitological confirmation for malaria case management. However, where they have been deployed, adherence to RDT results has been poor, especially when the test result is negative. Participants were given a free RDT and the appropriate treatment advice based on their RDT result. Short Message Service (SMS) text messages reiterating the treatment advice were sent to a randomly selected half of the participants one day after being tested. SMS text messages substantially increased adherence to RDT results for patients seeking care for malaria from privately owned drug retailers in Nigeria and may be a simple and cost-effective means for boosting adherence to RDT results if and when RDTs are introduced as a commercial retail product.

There is growing interest in franchising as a model that can be applied to reach social, as well as commercial gains, particularly in global health. Tiendas de Salud is a rural pharmacy franchise that brings essential medicines to rural villages in Guatemala, which was incubated through donor-funding but has transitioned to commercial ownership. This case study examines the community effects of the franchise program through qualitative interviews, observation, and analysis of store records.

The private sector plays a large role in health services delivery in low- and middle-income countries; yet significant gaps remain in the quality and accessibility of private sector services. Clinical social franchising, which applies the commercial franchising model to achieve social goals and improve health care, is increasingly used in developing countries to respond to these limitations. Despite the growth of this approach, limited evidence documents the effect of social franchising on improving health care quality and access. Read the publication here.

Readers are presented with a program case study and a planning dilemma: how can a social franchise program’s service-delivery model be adjusted to address cost-effectiveness, health impact, and quality? This case study can be used by teachers and practitioners for a real-world global health problem-solving exercise.