Can Individuals’ Beliefs Help Us Understand Nonadherence to Malaria Test Results? Evidence from Rural Kenya
36 Pages Posted: 7 Feb 2017
Date Written: February 3, 2017
Malaria testing remains relatively uncommon in endemic countries, individuals often purchase antimalarial drugs without diagnostically-confirmed malaria. More than a quarter of those testing negative still purchase first-line antimalarial therapy (artemisinin-based combination therapies, ACTs). ACT overuse depletes scarce resources available for subsidies, and contributes to parasite resistance. As part of a randomized experiment in Western Kenya that provided a subsidized rapid diagnostic test (RDT) and/or a conditionally-subsidized ACT for febrile individuals with diagnostically-confirmed malaria, we examine whether treatment decisions are associated with beliefs that the illness is malaria. We conceptualize treatment-seeking as two sequential decisions: whether (i) to get tested and (ii) to purchase ACT. First, we study whether prior beliefs are associated with each decision. Second, we analyze how these behaviors are associated with posterior beliefs (one week after the intervention). Prior beliefs are not associated with the decision to get tested, instead RDT price is the driving force. For malaria-negative individuals, prior beliefs do not explain ACT purchasing behavior and those who purchased ACT reported a higher posterior belief than those who did not. In order to improve utilization of information from malaria testing, further research is needed to understand how beliefs are shaped and how actions shape beliefs.
Keywords: Malaria, Diagnostic Test, Beliefs, Expectation, Adherence
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