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  • Chauncey Strauss posted an update 5 days, 3 hours ago

    Bennet and colleagues also make an important addition to the literature on the Affordable Medicines Facility—malaria (AMFm) intervention, since a comparison of ACT treatment coverage for countries that had the AMFm intervention is made with those for countries that did not have the AMFm intervention. However, the authors acknowledge that the higher ACT treatment coverage in those countries that had the AMFm intervention cannot be directly linked to the intervention itself. The authors\’ consideration that other related factors could have accounted for this is supported by figure 2C; in which this disparity is shown to emerge as early as 2007, even though the first AMFm ACTs reached some countries in August 2010 (p 53).The decline in malaria incidence and mortality observed in Africa has been attributed to multiple interventions; including vector control activities, and widespread deployment of insecticide treated nets (ITNs), rapid diagnostic tests, and ACTs. Increasing the low ACT treatment coverage and scaling-up diagnostics, particularly in the private sector, has the potential to further reduce malaria mortality. The predictive modelling, data imputation, and assumptions that went into producing the estimates presented in this paper show the need for more robust indices of ACT treatment coverage. Achieving this will require more detail to be included in routine household surveys, along with the introduction of health facility surveys and exit interviews for people seeking treatment for fever. This additional data collection will have important cost implications, but hold great potential benefit for informing the planning and implementation of large-scale interventions, and measuring their effect at both country and continental levels, ultimately saving cost.Routine childhood immunisation is one of the most successful and cost-effective public health interventions that have considerably reduced global child morbidity and mortality. However, annually, an estimated 18·7 million children under 1 year of age do not receive basic bethanechol chloride as part of an expanded programme of immunisation (EPI) worldwide, and millions of children die from vaccine-preventable diseases. Because of social issues and insufficient appreciation for immunisation, parents and caregivers forget or ignore the importance of immunisation or completing the entire series of vaccines. As a consequence, there is a continuation of the polio epidemic, large measles outbreaks, and high disease burden of vaccine-preventable diseases in children. In , Dustin Gibson and colleagues study showed the effectiveness of SMS reminders coupled with incentives in improving immunisation uptake and timelines in Kenya.The rapidly growing advancements in mobile technology have revolutionised global connectivity with 7 billion mobile phone users worldwide, most of which live in developing countries. The element of portability and sharing allows mobile phones to reach more people than through the internet alone, providing a great solution to challenges such as travel and complex intercultural contact. A substantial proportion of the population living below the poverty line has access to mobile phones. This has thus changed the mode of communication among people worldwide and provides a great potential for public health engagement. Mobile health (mHealth) and SMS-based interventions have successfully improved vaccination uptake in children. Although incentives have been used before to improve health-care outcomes, Gibson and colleagues\’ study showed a statistically significant effect of mobile phone-based incentives coupled with SMS for improving immunisation coverage and timelines in a low and middle-income country (LMIC) setup.Given the mobile phone access and acceptability in LMICs, there is considerable potential for mobile phone-based interventions to improve immunisation coverage in such settings. Previous studies assessing the effect of texting on vaccination have largely focused on flu vaccination in children and adolescents in the USA. There are limited data from LMICs on the role of mHealth-based SMS interventions in improving routine childhood immunisation coverage. Most of these studies assessed the conventional one-way text reminders and only a few studies compared reminder messages with educational and interactive (two-way) SMS messages related to vaccination uptake. However, in Gibson and colleagues\’ study SMS reminders as a stand-alone intervention did not improve immunisation coverage and the effect was only seen when SMS was combined with an incentive.

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