Health education messages can provide information and address a variety of misconceptions regarding the use of antimalarials. Common formats include posters, video clips, radio, and other forms of mass media. Other methods include peer education, mothers’ clubs, and school-based programs.

In Tanzania, popular misconceptions about SP were undermining adherence to treatment. The Tanzanian health service responded by creating health education messages to counter the belief that SP is ineffective because it lacks chloroquine’s immediate antipyretic plus anti-inflammatory effects. Other messages in Tanzania and elsewhere have focused on malaria’s symptoms and complications, correct dosing of antimalarial drugs, the use of oral versus injectable antimalarials, and persistent or recurrent symptoms following treatment (Ruebush et al., 1995; Foster, 1995). As with many health education messages (Engleman and Forbes, 1986; Helitzer-Allen et al., 1993; Denis, 1998) however, the Tanzanian malaria campaign was never formally evaluated.

One exception to the dearth of educational evaluations is a study conducted in Cambodia in which posters combined with video clips improved antimalarial adherence rates as much as 20 percent (Denis, 1998). The influence of posters alone was much more modest. Educational benefits were mainly reported among those who visited public and private health practitioners as opposed to consumers who purchased their drugs from vendors. While posters have been used widely in malaria education, this is the only study that has compared their effect on adherence with another form of mass media; namely video.

Many consumers in Africa, Asia and Latin America seek medical treatment outside the formal heath care sector (Foster, 1995). Although close-to-home treatment is desirable in theory, in practice, private sector vendors are frequently unable to provide appropriate advice, complete doses, or even the correct category of drug for a specific complaint (Bloland et al., 2003). One way of improving quality of private-sector treatment is to train drug sellers and shopkeepers. In western Nigeria, primary health care training of patent medicine vendors improved knowledge about malaria as well as other infectious disorders and malnutrition (Oshiname and Brieger, 1992). In Kenya, 500 private drug sellers were enrolled in a 2-4 day training workshop mounted by the Ministry of Health in conjunction with a public

Front Matter (R1-R20)

Executive Summary (1-16)

Part 1: A Response to the Current Crisis1 Malaria Today (17-60)

2 The Cost and Cost-Effectiveness of Antimalarial Drugs (61-78)

3 The Case for a Global Subsidy of Antimalarial Drugs (79-111)

4 An International System for Procuring Anitmalarial Drugs (112-122)

Part 2: Malaria Basics5 A Brief History of Malaria (123-135)

6 The Parasite, the Mosquito, and the Disease (136-167)

7 The Human and Economic Burden of Malaria (168-196)

8 Malaria Control (197-251)

9 Antimalarial Drugs and Drug Resistance (252-298)

Part 3: Advancing Toward Better Malaria Control10 Research and Development for New Antimalarial Drugs (299-311)

11 Maximizing the Effective Use of Antimalarial Drugs (312-328)

Acronyms and Abbreviations (329-333)

Glossary (334-346)

Index (347-364)