Benin outlet report 2008

In the 2008 ACTwatch outlet survey in Benin, a total of 1,176 outlets were sampled.  In 35 of the sampled outlets, an eligible provider was not available to participate; 15 outlets were not open at the time of the survey visit (up to three visits before exclusion); 15 outlets had permanently closed down; 4 providers refused to be interviewed; 4 outlets were inaccessible; and 7 outlets were unable to be interviewed for other reasons.  These outlets were excluded from the analysis.  Overall, 1,096 providers agreed to participate in the outlet survey.  Of these, 845 outlets reported having stocked antimalarials at any point in the three months prior to the interview, and 752 outlets stocked antimalarials at the time of the interview.

Availability of antimalarials

  • 68.6% of outlets had at least one antimalarial in stock.
  • 6.6% of all outlets stocked the government-recommended first-line treatment for uncomplicated malaria, artemether lumefantrine (AL), 20mg/120mg.
  • 65.8% of public health facilities, 77.1% of licensed pharmacies and 9.2% of private health facilities stocked AL.
  • Among other outlet types (shops, stalls, hawkers), 0.6% stocked AL while 63.2% stocked non-artemisinin therapies.

Availability of malaria diagnostics:

  • Among all outlets stocking antimalarials, 5.6% offered diagnostic testing services of some kind: 3.3% had microscopic blood testing and 3.9% offered rapid diagnostic tests (RDTs).
  • Diagnostic testing for malaria was available at 56.8% of public health facilities (largely RDTs), 13.7% of private health facilities, 3.2% of licensed pharmacies and less than 1% of other outlets.   

Price of antimalarials

  • The median price of the first-line treatment (AL) was USD 5.68, almost 35 times more expensive than the most popular antimalarial, chloroquine, which was USD 0.29.
  • All sectors charged a fee for antimalarials, but the median price of AL in public health facilities was one-fifth of the median price in the private sector (USD 1.17 compared to USD 6.25).
  • The median price of ACTs in the private sector was 2-4 times the minimum daily wage in Benin.

Volumes of antimalarials sold

  • 87.3% of all full adult malaria treatments sold/distributed in Benin were non-artemisinin therapies, the most common being chloroquine (55.6%).
  • ACTs accounted for 12.1% of all antimalarials sold/distributed.
  • The first-line treatment (AL) accounted for 7.5% of total distribution.
  • 66.4% of first-line treatment was distributed in the public sector and 29.0% in the private sector.
  • 83% of all antimalarials were sold/distributed in the private sector.
  • 53.2% of all antimalarials were sold/distributed by "other" outlets (shops, stalls, hawkers), nearly all (99.3%) non-artemisinin therapies.

For more results, see the full report, ACTwatch Outlet Survey, Benin, 2008 Survey Report.

The ACTwatch Outlet Survey, Benin, 2008 Survey Report presents the results of a cross‐sectional survey of antimalarial outlets conducted in Benin from October 17-31, 2008.

The objective of the outlet survey is to monitor levels and trends in the availability, price and volumes of antimalarials, and providers’ perceptions and knowledge of antimalarial medicines at different outlets. Price and availability data on diagnostic testing services are also collected.

A nationally representative sample of all outlets that could sell or provide antimalarials to a consumer was taken through a census approach in 19 sub-districts in Benin.  Sampling was conducted using a one-stage probability proportional to size (PPS) cluster design, with the measure of size being the relative sub-district population.

Outlet inclusion criteria for this study included outlets which stocked an antimalarial at the time of survey or at any time in the previous three months. An outlet was defined as any facility or point of sale with the potential to sell distribute or provide antimalarial drugs to individuals.  Outlets included in this survey were: 1) public health facilities (government hospitals, health centres, dispensaries, village health units, and other government health facilities); 2) Part One pharmacies (pharmacies licensed by the Ministry of Health); 3) private health facilities (private clinics, missionary hospitals, and NGO health centres); and 4) other outlets (shops and stalls located in and outside of markets, and hawkers/mobile vendors). See Appendix A of the full report for definitions and numbers of each type of outlet surveyed.

The outlet survey questionnaire consisted of three modules: 1) screening questionnaire, 2) audit sheet and 3) provider questionnaire. For all outlets, trained interviewers administered the screening questionnaire to collect information on the outlet type, location (including the outlet’s longitude and latitude) and information on availability of antimalarials.  Among those outlets that stocked antimalarials at the time of survey, the audit sheet was adminstered. For each antimalarial, information was recorded on the brand and generic names, strength, expiry, amount sold in the last week and price to the consumer. Among outlets that stocked antimalarials at the time of interview or in the past three months, the interviewer collected information on provider demographics, knowledge, and perceptions.  Interviewers also observed outlet licensing and storage conditions of medicines using the provider questionnaire.