Beyond home care without active treatment, the first step of home-based management of malaria (HMM) is the health provider-customer interactions that often lead to the purchase of drugs or herbs to treat symptoms. In Abidjan, Côte d'Ivoire, the quality and content of such interactions in pharmacies where antimalarials are sold officially, with illegal drug vendors and with herbal medicine sellers, vary considerably. Commercial encounters associated with adult illness episodes of locally identified malaria, observed in 2004-5, illustrate that customers present to sales points, on behalf of people who are ill, with a pre-established diagnosis and the intent of purchasing medication with which they have prior familiarity. Customers sought neither diagnosis nor clarification, and communication between vendor and customer was limited to minimal enquiries or suggestions. These findings have important implications related to the need for vendor training to support HMM and so ensure prompt and appropriate treatment outside clinical settings.
Keywords: Côte d'Ivoire; antimalarials; home-based management of malaria; malaria treatment; pharmacy.