Strengthening Malaria Service Delivery Through Supportive Supervision and Community Mobilization in an Endemic Indian Setting: An Evaluation of Nested Delivery Models

37 Pages Posted: 20 Apr 2016

See all articles by Ashis Das

Ashis Das

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Jed Friedman

World Bank - Development Research Group (DECRG); World Bank Group

Eeshani Kandpal

World Bank

GNV Ramana

World Bank

R. K. Das Gupta

Government of India

Madan Pradhan

Government of Odisha, Odisha - Department of Health And Family Welfare

Ramesh Govindaraj

World Bank

Date Written: June 1, 2014

Abstract

Malaria continues to be a prominent global public health challenge, in part because of the slow population adoption of recommended preventive and curative behaviors. This paper tests the effectiveness of two service delivery models designed to promote recommended behaviors, including prompt treatment seeking for febrile illness, in Odisha India. The tested modules include supportive supervision of community health workers and community mobilization promoting appropriate health seeking. Program effects were identified through a randomized cluster trial comprising 120 villages from two purposively chosen malaria-endemic districts. Significant improvements were measured in the reported utilization of bed nets in both intervention arms vis-?-vis the control. Although overall rates of treatment seeking were equal across the study arms, treatment seeking from community health workers was higher in both intervention arms and care seeking from trained providers also increased with a substitution away from untrained providers. Further, fever cases in both treatments were more likely to have received timely medical treatment (within 24 hours) from a skilled provider. The study arm with supportive supervision was particularly effective in shifting care seeking to community health workers and ensuring prompt diagnosis and treatment. A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization can be effective in shifting care seeking and increasing preventive behavior, and thus may be used to strengthen the national malaria control program.

Keywords: Health Monitoring & Evaluation, Housing & Human Habitats, Disease Control & Prevention, Population Policies, Adolescent Health

Suggested Citation

Das, Ashis and Friedman, Jed Arnold and Kandpal, Eeshani and Ramana, GNV and Das Gupta, R. K. and Pradhan, Madan and Govindaraj, Ramesh, Strengthening Malaria Service Delivery Through Supportive Supervision and Community Mobilization in an Endemic Indian Setting: An Evaluation of Nested Delivery Models (June 1, 2014). World Bank Policy Research Working Paper No. 6901. Available at SSRN: https://ssrn.com/abstract=2445747

Jed Arnold Friedman

World Bank - Development Research Group (DECRG)

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

World Bank Group ( email )

1818 H Street, N.W.
Washington, DC 20433
United States

Eeshani Kandpal

World Bank ( email )

1818 H Street, NW
Washington, DC 20433
United States

GNV Ramana

World Bank

1818 H Street, NW
Washington, DC 20433
United States

R. K. Das Gupta

Government of India

India

Madan Pradhan

Government of Odisha, Odisha - Department of Health And Family Welfare

India

Ramesh Govindaraj

World Bank

1818 H Street, NW
Washington, DC 20433
United States

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