ACCESS

Partnership objectives

  1. Understand and improve factors influencing access to health care services, especially effective malaria treatment and care in Tanzania.
  2. Improve overall access to quality healthcare in four rural districts in Tanzania.

ACCESS project in Tanzania improves access to malaria treatment in a comprehensive way – e.g. by improving the quality of care à ACCESS ACCESS project in Tanzania improves access to malaria treatment in a comprehensive way – e.g. by improving the quality of care à ACCESS Copyright Novartis Foundation for Sustainable Development

What are the health needs and challenges?

Access to healthcare and medicines, such as artemisinin-based combination therapy (ACTs) for treatment of malaria, remains a challenge for many people in developing countries such as Tanzania.

Availability and affordability of safe and efficacious medicines are crucial factors impacting access, which in turn affects the ability to combat diseases, as well as child and maternal mortality.

Description of partnership activities and how they address needs and challenges

The Novartis Foundation for Sustainable Development uses an access to healthcare framework, defining the degree to which a patient’s resources, needs and expectations (demand) are aligned with a healthcare system’s services and providers (supply). Access to healthcare can only be sustainable if the local healthcare system and services are aligned with well-informed demand. Based on this framework, ACCESS developed five interventions to improve access in a comprehensive way:

  • Assessing the quality of health services in health facilities and training health workers
  • Introducing the Rapid Diagnostic Test for malaria
  • Implementing social marketing campaigns to optimise appropriate demand for effective malaria treatment
  • Supporting women’s saving groups to empower women and improve their financial means, including for access to healthcare
  • Supporting Community Health Funds (CHF) to achieve better healthcare access and financial protection of the population.

ACCESS worked to make the quality assessment approach (currently paper-based) more manageable, viable and more efficient in terms of time, financial and human resources, and eventually to be scalable. To do this the Novartis Foundation collaborated with Vodafone in 2011 to develop an ICT-based version of the paper-based assessment tool called e-TIQH (electronic Tool to Improve the Quality of Healthcare).

Lessons learned

Supportive supervision is the single most influential factor on the final outcome of the program. The comprehensive access framework of activities operating integrated to the targeted malaria approach is also an essential element of the success of ACCESS.      

Summary of impact through December 2013 and forward looking information

ACESS I ran from 2003-2007; ACCESS II from 2008 to 2011.

From 2004 to 2008, results show that the proportion of investigated fever cases treated with a recommended antimalarial within 24 hours increased from 66% to 89%, indicating earlier treatment-seeking behavior. The proportion of investigated fever cases treated with a recommended antimalarial within 24 hours in the correct dosage also improved from 43% to 63%.

Child mortality rates decreased by 42.5% from 14.6 c/1000py in 1997 to 8.4 c/1000py in 2009. All malaria control interventions, inclusive of the ACCESS program, were associated with decreases in child mortality.  (S.Alba et al., Int. J. Epidemiol.)

To ensure sustainability beyond ACCESS II, the team is working on integrating project components into district health plans, e.g. funds for conducting regular assessments of health services and for rewarding performance of health workers. Furthermore, the m-health-based performance assessment tool will facilitate effective supportive supervision managed by the district authorities. 

Visit the successor project, ISAQH, click here

Videos

Fighting Malaria in Tanzania

Partnership information

Company(ies) Novartis

Partner(s) Ifakara Health Institute, Swiss Tropical and Public Health Institute (Swiss TPH)

Type of Partner(s) Academia / Hospitals

Therapeutic Focus Infectious Diseases, Women and Children's Health

Disease(s) Children's Health, Malaria

Program Type(s) Availability of Treatment - Differential Pricing, Availability of Treatment - Product Donations, Health System Infrastructure - Training, Prevention Programs - Awareness & Outreach

Targeted Population(s) Children, Marginalised / Indigenous People, Men, Patients in needs of treatment, People with low income, Women

Region(s) Sub-Saharan Africa

Number of Countries 1

Country(ies) Tanzania

Start Date 2003

More information ACCESS project

Completed date 2012