Rectal Artesunate Information Education and Communication Report (RAISEC)

01 Dec 2021
Medicines for Malaria Venture, University of Malawi College of Medicine, WellSense, UNITAID

In communities located several hours from a health facility where intravenous treatment for severe malaria would be administered, the World Health Organization (WHO) recommends rectal artesunate (RAS) also known as artesunate rectal capsules (ARC) be used as a community-based pre-referral intervention for children, to rapidly reduce parasitaemia and allow for transit time to reach treatment. This pre-referral intervention, administered by a community health worker or health surveillance assistant (HSA) in the case of Malawi, can only be of benefit if the continuum of care is uninterrupted. In other words: the patient presents early enough to benefit from the intervention; the pre-referral intervention is administered promptly and correctly and the patient is urgently referred to a health facility where intramuscular or intravenous treatment is administered correctly, over the correct period and followed up with oral ACT.

This study intended to inform future programming in relation to the role that Information – Education – Communication (IEC) could play in enhancing this continuum of care.  This study used a tailor-crafted IEC RAS toolkit (https://www.mmv.org/access/tool-kits/rectal-artesunate-tool-kit), developed by Medicines for Malaria Venture (MMV), and field tested for comprehension and appropriateness in Malawi and Senegal in 2015. The study hypothesized that community exposure to targeted IEC would increase early presentation by the
caregiver at the village health clinic (VHC) for Rectal Artesunate (RAS) and the caregiver acceptance of RAS; and that community health worker (CHW/HSA) exposure to a targeted toolkit would increase appropriate assessment, administration of RAS and referral, and in turn enhance prompt compliance with referral instructions among caregivers.