Founded in 2002 by President William J. Clinton, the Clinton Health Access Initiative (CHAI) is a global health organization committed to strengthening integrated health systems around the world and expanding access to care and treatment for HIV/AIDS, malaria and other illnesses. Based on the premise that business oriented strategy can facilitate solutions to global health challenges, CHAI acts as a catalyst to mobilize new resources and optimize the impact of these resources to save lives, via improved organization of commodity markets and more effective local management. By working in association with governments and other NGO partners, CHAI is focused on large scale impact and, to date, CHAI has secured lower pricing agreements for treatment options in more than 70 countries.
CHAI began its malaria program in Cambodia in 2007. In past, CHAI provided technical assistance to the national malaria program (CNM) to improve central quantification and forecasting methods for malaria commodities. CHAI also piloted a mHealth SMS-based inventory alert system at peripheral health levels to improve the supply chain management for malaria commodities. Since 2011, CHAI has supported CNM in engagement with the private sector through Public-Private Mix program.
In Cambodia, the majority (approximately 70%) of malaria patients seek treatment in the private sector. CNM and partners developed and instigated a PPM program for Malaria in order to progress towards the objective of malaria elimination. The project, started in Nov 2011 after a one year pilot, focuses on the collaboration between the public sector and registered private providers to ensure that all patients receive parasitological diagnosis and appropriate drug regimens; those patients are referred to the private sector when necessary and to keep counterfeit drugs and monotherapies from being sold in the market. Another motivation behind the implementation of the PPM was to facilitate the collection of routine surveillance data to be from private sector providers. The emergence of artemisinin resistance in Western Cambodia also pushed for an effective strategy to actively engage with the private sector. CHAI helped CNM to start the PPM unit and continues to support the scale up of the program and further develop PPM strategy at central and peripheral levels.
Recent malaria prevalence surveys in Cambodia have found the prevalence of malaria among mobile populations to be substantially higher than the general population. The frequent movement of these mobile populations into the remote forested areas, especially along the borders with neighbouring countries where malaria incidence is high, represents a major risk of malaria transmission and a challenge to Cambodia's plan on malaria elimination. This high-risk group is usually poorly connected to routine public health interventions and community based surveillance systems and, therefore represents a critical group for malaria elimination efforts. CHAI recently obtained a grant for operational research on the evaluation of a voice-based technology to improve access to diagnosis and treatment among high-risk mobile population of forest-goers in Ratanakiri (north-eastern Cambodia).
CNM has planned to scale up the SMS-based inventory management tool which was piloted by CHAI in past and CHAI is expected to provide technical assistance in the process. There are also plans to initiate health financing work for malaria in Cambodia. Apart from this, CHAI global malaria team is developing a regional strategy in Southeast Asia for malaria which may expand the scope of work.
Work objectives may include: 1) Conduct an assessment of the PPM program and recommend measures to improve its effectiveness. This will require strong partnership with the PPM coordinator and will involve numerous field visits and discussions with stakeholders across the health system. 2) Design and pilot an incentive system in collaboration with PPM Coordinator at CNM for private providers. 3) Support the implementation of voice-based technology project (mobile populations) on the field in coordination with project partners.
The definite objectives may vary based on the situation and period of placement, and will be finalized before the commencement of the work.
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