Malaria and children: Progress in intervention coverage - Unicef

Since 2003 nearly all sub- Saharan countries
have shifted their national drug policies to
highly effective artemisinin-based combination
therapies, with financing for and procurement
of these drugs increasing since 2005
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Malaria and children
the recommended time period: The Gambia
(52 per cent in 2006), Tanzania (51 per cent in
2005), Ghana (48 per cent in 2006) and Sierra
Leone (45 per cent in 2005).
Trends in antimalarial medicine use
The percentage of febrile children receiving antimalarial
medicines declined from 41 per cent in
2000 to 34 per cent in 2005, based on a subset of
22 sub- Saharan countries that had trend data for
2000 and 2005 covering nearly half the region’s
population of children under age five. However,
it appears that these findings may be the result
of decreasing chloroquine use among febrile
children, which is no longer recommended by
the World Health Organization due to widespread
resistance and treatment failures. Further
analysis of these data is needed to better understand
the reasons behind these trends in specific
countries.
During this same time period the region entered
a major transition period, with national drug
policies changing and efforts to improve access
to more effective treatments being scaled up.
Since 2003 nearly all sub- Saharan countries have
shifted their national drug policies to highly
effective artemisinin-based combination therapies,
with financing for and procurement of
these drugs increasing since 2005 (map 4). These
actions, along with more investment in delivery
systems within countries, suggest that more children
with malaria will likely receive prompt and
effective treatment in the coming years.
Disparities in malaria treatment within countries
High treatment coverage across a number of
countries in sub- Saharan Africa hides important
within-country disparities in treatment coverage
(figure 13). As with insecticide-treated
net coverage, children living in rural areas and
the poorest households are more likely to contract
malaria—and less likely to receive appropriate
treatment. While boys and girls living in
sub- Saharan Africa are equally likely to receive
Figure 13 African children with fever living in rural
areas and in poorest households are less
likely to receive antimalarial medicines
Male 30
Female
Urban
Rural
Richest
Fourth
Middle
Second
Poorest
26
31
31
malaria treatment for fever, some 42 per cent of
febrile children living in urban areas receive antimalarial
medicines compared with 32 per cent
of rural children. Similarly, children living in
the richest households are about 1.5 times more
likely to receive treatment than those in the poorest
households. 23
32
31
34
37
42
0 10 20 30 40 50
Percentage of febrile
children under age five
receiving any antimalarial
medicine, sub-Saharan
Africa, by gender,
residence and wealth
index quintiles,
2003–2006
Source:
UNICEF global malaria
database, based on 18
(gender), 28 (residence)
and 23 (wealth) Multiple
Indicator Cluster
Surveys, Demographic
and Health Surveys and
Malaria Indicator
Surveys for 2003–2006.
Figure 14 Many African children with fever taking
antimalarial medicines receive treatment
only at home
Both at
health facility
and at home
17%
At health
facility
42%
At home
42%
Percentage of febrile
children under age five
receiving antimalarial
medicines, by location,
2000–2006
Source:
UNICEF global malaria
database, based on 24
Multiple Indicator
Cluster Surveys in
sub-Saharan Africa for
2000–2006.
Progress in the fight against malaria
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