Malaria RDT Market Creation and Stimulation The Kenya Experience - Patricia Njiri Clinton Health Access Initiative Kenya Malaria rapid diagnostic tests (RDTs) and fever case management in the private health care sector in Africa: a consultative working meeting Entebbe, Uganda Oct 20 &21, 2015
Presentation outline Private sector context CHAI experience supporting NMCP in accelerating uptake of RDTs in the private sector Lessons learnt Challenges
Outlets surveyed Kenya provides an opportunity to increase RDT sale and use in the private sector Case management guidelines indicate that all suspected malaria cases should receive a confirmatory test (RDT or Microscopy) 30% - 40% of population seeks treatment for febrile illnesses in this sector Characterized by private for profit and private not for profit outlets, as well as formal and informal Comprises of hospitals, clinics, nursing homes, laboratories, pharmacies* (wholesale and retail), Presence of strong regulation, RDTs can be sold and used in registered privatefor-profit hospitals, clinics, laboratories, and pharmacies*. 35% - 40% of ACTs are accessed through the private sector Availability of ACTs 95.2%. Non Artemisinin based therapies 60.2% Coverage of diagnostic services 21.1% 30% 20% 10% 0% 21.1% Functional malaria diagnostic service available N=417 12.9% 10.3% Functional microscopy service Malaria RDTs available Ref: Availability of quality dispensing practices of ACTs and RDTs in the private sector, NMCP, October 2013
With adoption of the Test, Treat and Track policy, CHAI expanded scope from treatment access to supporting NMCP to increase malaria diagnostic capacity by accelerating the uptake of mrdts in the private sector. Rapid diagnostic test costs and markups USD >$1 Lower retail prices Commit high quality manufacturers to a preferred pricing scheme for malaria RDTs Promote recommended retail price to providers and consumers. $0.65 $0.65 CHAI helped RDT manufacturers understand private sector market potential Negotiated low cost model for Kenya and Tanzania in which importers could access low manufacturer prices in return for low yet sustainable margins Price to importer Avg. retail price $0.29 Negotiated price to importer Suggested retail price Pre intervention Post intervention 4
From Q3 2013 date, market creation and stimulation activities have been implemented to support the uptake of malaria RDTS in the Private Sector: Expand distribution channels Identify existing distributors Establishing other interested distributors e.g. AMFm first line buyers Encourage and support aggressive use of existing distribution networks Generate market intelligence to influence risk averse members Demand generation Distinguish the brand/commodity/service Health provider training through CMEs and other private sector targeted trainings Retail level promotional activities & material distribution Public awareness through mass media and interpersonal communication* Targeted marketing based on post training uptake 5
Resultant low cost mrdt sales growth RDT SALES ( W/PSK) 600000 500000 400000 300000 200000 100000 0 Total RDT SALES ( Wo/PSK) 180000 160000 140000 120000 100000 80000 60000 40000 20000 0 2013 2014 2014 2014 2014 2015 2015 2015 Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter 4-2013 1-2014 2-2014 3-2014 4-2014 1-2015 2-2015 3-2015 6
Key lessons learnt in engaging the private sector: Identifying, mapping and categorizing Adopt innovative approaches to attract interest and participation Use a consultative and informative approach Planning for and with the private sector Involve the sector in routine reporting, M&E and OR Routinely updating stakeholders in the sector Align with existing regulation
Challenges Disconnect between potential market and actual market Product uptake varies greatly from uptake of a service; especially at retail level Unresolved regulatory issues
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