title: Intermittent preventive treatment for malaria and anaemia control in Tanzanian infants; the development and implementation of a public health strategy.
abstract: Minimizing the time between efficacy studies and public health action is important to maximize health gains. We report the rationale, development and implementation of a district-based strategy for the implementation of intermittent preventive treatment in infants (IPTi) for malaria and anaemia control in Tanzania. From the outset, a research team worked with staff from all levels of the health system to develop a public-health strategy that could continue to function once the research team withdrew. The IPTi strategy was then implemented by routine health services to ensure that IPTi behaviour-change communication materials were available in health facilities, that health workers were trained to administer and to document doses of IPTi, that the necessary drugs were available in facilities and that systems were in place for stock management and supervision. The strategy was integrated into existing systems as far as possible and well accepted by health staff. Time-and-motion studies documented that IPTi implementation took a median of 12.4 min (range 1.6-28.9) per nurse per vaccination clinic. The collaborative approach between researchers and health staff effectively translated research findings into a strategy fit for public health implementation.
authors.affiliation: Ifakara Health Institute, P.O. Box 78373, Dar es Salaam, Tanzania. manzif@yahoo.com
authors.forename: Fatuma
authors.initials: F
authors.lastname: Manzi
authors.forename: Joanna
authors.initials: J
authors.lastname: Schellenberg
authors.forename: Yuna
authors.initials: Y
authors.lastname: Hamis
authors.forename: Adiel K
authors.initials: AK
authors.lastname: Mushi
authors.forename: Kizito
authors.initials: K
authors.lastname: Shirima
authors.forename: Alex
authors.initials: A
authors.lastname: Mwita
authors.forename: Azma
authors.initials: A
authors.lastname: Simba
authors.forename: Neema
authors.initials: N
authors.lastname: Rusibamayila
authors.forename: Mary
authors.initials: M
authors.lastname: Kitambi
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso
authors.forename: Hassan
authors.initials: H
authors.lastname: Mshinda
authors.forename: David
authors.initials: D
authors.lastname: Schellenberg
mesh_terms: D000740:Anemia / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control*; D000962:Antimalarials / Q000627:therapeutic use; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education* / Q000458:organization & administration; D006801:Humans; D017589:Immunization Programs / Q000379:methods* / Q000458:organization & administration; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D017780:Malaria Vaccines; D008297:Male; D011634:Public Health / Q000379:methods*; D011739:Pyrimethamine / Q000627:therapeutic use; D013413:Sulfadoxine / Q000627:therapeutic use; D013636:Tanzania / Q000453:epidemiology; D013996:Time and Motion Studies
chemical_list: D000962:Antimalarials; D017780:Malaria Vaccines; D013413:Sulfadoxine; D011739:Pyrimethamine