Twenty-three studies were included: six RCTs (n=3,310), four controlled pre/post studies (n=982), eight uncontrolled pre/post studies (n=1,870), and five studies that appeared to be post-only studies with controls (n=1,535). Eleven studies reported composite measures of treatment based on the Roll Back Malaria outcome indicator, but only two of these included all its components.
Interventions targeting providers (16 studies): Didactic in-service training of formal providers did not appear successful in achieving prompt and effective treatment of malaria, but training involving interactive learning and clinical practice tended towards more positive results. Interventions involving informal providers, especially in the private sector, appeared relatively effective. These included involving drug vendors in the design of training, and ongoing education and supervision of drug vendors and community members. Training of community volunteers (in particular school teachers) modestly improved outcomes.
Interventions targeting users (14 interventions): Health education programmes were generally much less successful than provision of specific information on how to take anti-malarial drugs (e.g. pre-packaging of drugs, inclusion of both pictorial and verbal instructions) in changing behaviour.