Benin Outlet Surevy, ACTwatch 2011...Commune health centres ‐ the next level ‐ are usually...

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Appendices

ACTs classified as quality assured

Active ingredients Formulation and strength

Manufacturer Manufacture site Brand name Package size

Artesunate + Amodiaquine

Tablets 50mg + 150mg

Guilin Pharmaceutical Co. Ltd

Guilin, Guangxi, China Arsuamoon (1‐6yrs;7‐13yrs; Adults)

6;12;24


Tablets 50mg + 153mg / 153.1mg

Ipca Laboratories Limited

Dadra and Nagar Haveli (U.T.), India

AS‐AQ Generic (Child; Junior; Adult)

6;12;24


Tablets 50mg + 153mg / 153.1mg

Ipca Laboratories Limited


Larimal (Child; Junior; Adult)

6;12;24


Tablets 25mg + 67.5mg

Sanofi‐Aventis Group

MAPHAR Laboratories, Casablanca, Morocco

Coarsucam 25mg/67.5mg (Infant)

3





Coarsucam 50mg/135mg (Toddler)

3





Coarsucam 100mg/270mg (Child; Adult)

3;6


Tablets 25mg + 67.5mg



Winthrop 25mg/67.5mg (Infant)

3





Winthrop 50mg/135mg (Toddler)

3





Winthrop 100mg/270mg (Child; Adult)

3;6



Strides Arcolab Limited

Bangalore, India ACTipal (Madagascar) 3, 6, 12


Tablets 50mg + 153mg (200mg salt)

Cipla Ltd Patalganga, India; Goa, India

Falcimon Kit & Serenadose (DRC) (Young children up to 6yrs; Children 7‐13yrs; Adults)

6;12;24

Artemether + Lumefantrine


Novartis Pharma Beijing, China; Suffern, USA

Coartem 20/120 6;12;18;24


Tablets 20 gm+ 120mg

Ajanta Pharma Ltd Paithan, Aurangabad, Maharashtra, India

Artefan 20/120 6;12;18;24


Dispersible Tablets 20mg + 120mg

Novartis Pharma AG Novartis Pharmaceuticals Corporation, Suffern, USA

Coartem‐D 6;12



Cipla Ltd Patalganga, India; Himachal Pradesh, India

Lumartem (5‐15kg; 15‐25kg; 25‐35kg; >=35kg)

3;6;12;18;24



Ipca Laboratories Ltd


Lumerax 20/120 6;12;24



Ipca Laboratories Ltd


AL Generic 6;12; 18;24

Artesunate + Sulfadoxine / Pyrimethamine

Tablets 50mg + 500mg/25mg


Guilin, Guangxi, China Artecospe Co‐blistered 6+2

Artesunate + Sulfadoxine / Pyrimethamine

Tablets 100mg + 500mg/25mg


Guilin, Guangxi, China Artecospe Co‐blistered 6+3

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Nationally registered ACTs

Benin’s nationally registered ACTs as of September 200823

Active ingredients Formulation Strength Manufacturer Manufacture

Site Brand Name

Artesunate / Amodiaquine Tablet 200mg / 200mg Dafra Belgium Amonate

Artesunate / Amodiaquine Tablet 50mg / 153mg Ajanta India Apoxin

Artesunate / Amodiaquine Tablet 50mg / 150mg Guilin pharma China Arsuamoon

Artesunate / Amodiaquine Tablet 50mg / 153mg Sanofi Aventis Morocco Arsucam

Artesunate / Amodiaquine Tablet 100mg / 153mg Odypharm England Artediam

Artesunate / Amodiaquine Tablet 100mg / 300mg Pfizer USA Camoquin Plus

Artesunate / Amodiaquine Tablet 200mg / 600mg Pfizer USA Camoquin Plus

Artesunate / Amodiaquine Tablet 25mg / 67.5mg Sanofi Aventis Morocco Coarsucam

Artesunate / Amodiaquine Tablet 50mg / 135mg Sanofi Aventis Morocco Coarsucam

Artesunate / Amodiaquine Tablet 100mg / 270mg Sanofi Aventis Morocco Coarsucam

Artesunate / Amodiaquine Tablet 50mg / 153mg Ipca India Larimal

Artesunate / Amodiaquine Tablet 50mg / 200mg Macleods India Macsunate Plus

Artesunate / Amodiaquine Tablet 25mg / 75mg Medinomics India Malmed

Artemether / Lumefantrine Tablet 20mg / 120mg Ajanta India Artefan



Artemether / Lumefantrine Tablet 20mg / 120mg Novartis Switzerland Coartem

Artemether / Lumefantrine Powder 15mg / 90mg Dafra Belgium Co‐Artesiane

Artemether / Lumefantrine Suspension 360mg / 2160mg / 120ml

Dafra Belgium Co‐Artesiane


Dafra Belgium Co‐Artesiane

Artemether / Lumefantrine Suppository 20mg / 120 mg Bliss Gvs India Lonart

Artemether / Lumefantrine Tablet 20mg / 120mg Bliss Gvs India Lonart


Bliss Gvs India Lonart

Artemether / Lumefantrine Tablet 40mg / 240mg Imex Health India Lufanter

Artemether / Lumefantrine Tablet 20mg / 120mg Cipla India Lumartem

Artemether / Lumefantrine Tablet 20mg / 120mg Macleods India Lumether

Artesunate / Mefloquine Granules 50mg / 125mg Mepha Switzerland Artequin Paediatric

Artesunate / Mefloquine Tablet 100mg / 125mg Mepha Switzerland Artequin



Artemisinine / Naphthoquine Tablet 125mg / 50mg Kunming China Arco

Artesunate / Sulfamethoxypyrazine / Pyrimethamine

Tablet ‐‐

Stallion India Artecure

Continued on following page

23 Nationally registered ACTs were compiled through the Ministry of Health in Benin.

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Active ingredients Formulation Strength Manufacturer Manufacture

Site Brand Name

Artesunate / Sulfadoxine / Pyrimethamine

Tablet 100mg / 500mg / 25mg

Plethico India Artedar


Tablet 100mg / 250mg / 12.5mg

Denk pharma Germany AsunateDenk 100 Plus



Denk pharma Germany AsunateDenk 200 Plus


Tablet 100mg / 250mg / 12.5mg

Dafra Belgium Co‐Arinate



Dafra Belgium Co‐Arinate

Dihydroartemisinin / Piperaquine

Granules 15mg / 120mg Steyuan pharm China Darte‐q


Capsule 40mg / 320mg Steyuan pharm China Darte‐q


Tablet 40mg / 320mg Holleypharm China Duo‐cotecxin


Tablet 40mg / 320mg Laboratoire Salvat India Malacur


Suspension 80mg / 640mg / 80ml Bliss Gvs India P‐Alaxin

Dihydroartemisinin / Piperaquine / Trimethoprim

Tablet 32mg / 320mg / 90mg Tonghe Pharma China Artecom

Dihydroartemisinin / Sulfadoxine / Pyrimethamine

Tablet 60mg / 500mg / 25mg Bliss Gvs India Alaxin Plus

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Final sample

List of clusters (Arrondissements) sampled, Benin, 2011. Refer to page 13 for an explanation of the booster sample approach for this survey.

Department Commune Arrondissement Censused cluster or booster sample?

Alibori Banikoara Toura Census

Alibori Banikoara PHF booster sample

Alibori Karimama Birni‐Lafia Census

Alibori Karimama PHF booster sample

Alibori Pharmacy booster sample

Atacora Boukoumbe Tabota Census

Atacora Boukoumbe PHF booster sample

Atacora Pharmacy booster sample

Atlantique Abomey‐Calavi Godomey Census

Atlantique Abomey‐Calavi PHF booster sample

Atlantique Toffo Ague Census

Atlantique Toffo PHF booster sample

Atlantique Pharmacy booster sample

Borgou Bembereke Gomia Census

Borgou Bembereke PHF booster sample

Borgou Perere Sontou Census

Borgou Perere PHF booster sample

Borgou Pharmacy booster sample

Collines Dassa‐Zoume Kpingni Census

Collines Dassa‐Zoume PHF booster sample

Collines Ouesse Kilibo Census

Collines Ouesse PHF booster sample

Collines Save Kaboua Census

Collines Save PHF booster sample

Collines Pharmacy booster sample

Couffo Djakotome Djakotomey I Census

Couffo Djakotome PHF booster sample

Couffo Pharmacy booster sample

Donga Bassila Penessoulou Census

Donga Bassila PHF booster sample

Donga Pharmacy booster sample

Littoral Cotonou 1st Arrondissement Census

Littoral Cotonou 9th Arrondissement Census

Littoral Cotonou PHF and pharmacy booster sample

Mono Grand‐Popo Sazoue Census

Mono Grand‐Popo PHF booster samples

Mono Pharmacy booster sample

Continued on following page

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Department Commune Arrondissement Censused cluster or booster sample?

Oueme Bonou Bonou Census

Oueme Bonou PHF booster sample

Oueme Porto‐Novo 2nd Arrondissement Census

Oueme Porto‐Novo PHF booster sample

Oueme Pharmacy booster sample

Plateau Pobe Pobe Census

Plateau Pobe PHF booster sample

Plateau Pharmacy booster sample

Zou Bohicon Lissezoun Census

Zou Bohicon PHF booster sample

Zou Pharmacy booster sample

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Survey team List of staff members involved in the survey, Benin, 2011.

Team Leaders InterviewersMoudachirou BIAOU Abdoul Ramane CHABI Tayéwo CHACON Roland AGBESSI Gilles ACCROMBESSY Nellie AGUIDI Epiphane ABOGOURIN Additional quality control and supervision Emmanual ACAKPO Wilfred ADJANOHOUN Roger ATCHOUTA K. Abdou Raman OLODO Sai Sotima TCHANTIPO

Laminou ASHANTIBen Youssouf BIO BANGANA Israel DOVONOU Rachidatou CHABI GADO Jean Claude GLELE Yves KOTAN Marcellin ODOULAMI Ghyslaine BALOGOUN Noel Dona HOUETO Rafatou KOKOKO Géraldo OGNIN Rémi EKON Gilles CODJIA Hermine Lisette LOKOSSOU Prudencio NOUGLOKOU Armelle DAHOUNLINTON Augustine KPOTON Thierry ASSOGBA Oscar MEDO Baudoin ADINAKOU Hermione DAGNON Constant GANDJI Gynette GINDEHOU Maryse OGOULOLA Marc ADJERAN Serge Arnaud HOUNNOU Virginie GANGBADJO

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Description of outlet types visited for this survey 24

Public / Not for Profit Sector

Public Health Facilities N Description

Referral hospital (Hôpital de zone, or larger)

10

Government‐run health facilities that provide prescription medicine following medical consultation or diagnosis. Fees are usually charged for consultations and medicines. Arrondissement health centres are the first‐level of facility‐based public health care, and are usually staffed by nurses, a midwife, and auxiliary staff. They usually include a dispensary and maternity ward, although these facilities may also exist on their own. Commune health centres ‐ the next level ‐ are usually staffed by a doctor, nurses, and midwives. Across Benin’s 34 health zones, there is an average of 2 communes per zone. Health‐zone level hospitals and the national referral hospital in Cotonou receive first‐level referral services and typically are staffed with a surgeon and offer specialist health practitioners. Village health units are staffed by voluntary community health workers and are linked to an arrondissement or communal health centre.

Commune health centre 27

Arrondissement health centre 117

Dispensary 17

Maternity 11

Village health unit 22

Community health workers N Description

Community health workers (CHWs) 54

This cadre of staff works at the community‐level, providing diagnosis and treatment where appropriate, and referring patients when required. CHWs are trained and supported by a variety of international NGOs, in partnership with the Ministry of Health.

Private, not for profit facilities N Description

Non‐Governmental Organization (NGO) hospital / health centre

85 These facilities provide prescription medicine following medical consultation or diagnosis. They are usually staffed with qualified health practitioners, though some smaller clinics run by NGOs have less well qualified staff. Missionary hospital / clinic 8

24 In total, 2,966 outlets were enumerated during data collection. The outlet classification was missing for 6 cases and they are therefore

excluded from the breakdown presented here.

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Private‐for‐Profit Sector

Private facilities N Description

Private hospital / clinic 171

These are non‐governmental health facilities. Private clinics are smaller than hospitals and many of them are not registered with the Ministry of Health. They provide consultations and examinations, and sell prescription medicines at commercial prices.

Registered Pharmacies N Description

Pharmacy 205

Registered pharmacies are licensed by the Ministry of Health and sell prescription medicine at commercial prices. The outlets are staffed by qualified health practitioners, with oversight/supervision provided by a pharmacist. They sell all classes of drugs and are highly regulated.

General Retailers N Description

Supermarket 12 Businesses/points‐of‐sale which sell fast moving consumer goods (e.g. food, household products), in addition to some medicines (most often antipyretics). Drugs sold at these locations are not regulated. Boutiques are more formal structures than stalls, ranging from lockable‐steel structures in markets, to outlets located in an arcade of shops, or occupying the ground floor of a house. Supermarkets are larger than boutiques, both in floor space and in the range of products they stock.

Boutique 815

Boutique (in a market) 33

Stall (outside a market) 1,011 Stalls sell a variety of products that are displayed on tables (for example, on the roadside or in populated areas). They sell fast moving consumer goods and sometimes medicines. Drugs sold at these locations are not regulated. Stall (in a market) 221

Itinerant drug vendors N Description

Hawkers 141 Itinerant salesmen who often sell products of unknown origin, including medicines.

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Pharmacy

NGO health centre (Centre medico social)

Medicine selection carried by a hawker

Boutique (in a market)

Stall (outside a market)

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Questionnaire

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Evid

dence for M

Malaria Me

edicines P

Policy

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