Abstract:
A major puzzle in malaria treatment remains the dual problem of underuse and overuse of malaria
medications, which deplete scarce public resources used for subsidies and lead to drug resistance.
One explanation is that health behaviour, especially in the context of incomplete information, could
be driven by beliefs, pivotal to the success of health interventions. The objective of this study is to
investigate how population beliefs change in response to an experimental intervention which was
shown to improve access to rapid diagnostic testing (RDT) through community health workers
(CHWs) and to increase appropriate use of anti-malaria medications. By collecting data on individu-
als’ beliefs on malaria testing and treatment 12 and 18 months after the experimental intervention
started, we find that the intervention increases the belief that a negative test result is correct, and
the belief that the first-line anti-malaria drugs (artemisinin-based combination therapies or ACTs)
are effective. Using mediation analysis, we also explore some possible mechanisms through which
the changes happen. We find that the experience and knowledge about RDT and experience with
CHWs explain 62.4% of the relationship between the intervention and the belief that a negative test
result is correct. Similarly, the targeted use of ACTs and taking the correct dose—in addition to ex-
perience with RDT—explain 96.8% of the relationship between the intervention and the belief that
the ACT taken is effective. As beliefs are important determinants of economic behaviour and might
guide individuals’ future decisions, understanding how they change after a health intervention has
important implications for long-term changes in population behaviour.
