Nov 16, 2016 - Stock outs, difficulties in reaching out to Migrant and Mobile Populations (MMPs), insufficient means of transportation and dwindling worker ...
Village malaria worker performance key to the elimination of arte…in-resistant malaria: a Western Cambodia health system assessment
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Session 131 - Poster Session C: Presentations and Light Lunch
1544 - Village malaria worker performance key to the elimination of artemisinin-resistant malaria: a Western Cambodia health system assessment $ November 16, 2016, 12:00 - 1:45 PM
& Itinerary
% Hilton - Grand Ballroom and Grand Salon
Authors Sara E. Canavati1, Saranath Lawpoolsri2, Cesia E. Quintero3, Po Ly4, Chea Nguon4, Sasithon Pukrittayakamee5, David Sintasath6, Pratap Singhasivanon2, Koen Peeters Grietens7, Maxine Anne Whittaker8 1Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University/Centre for Biomedical Research, Burnet Institute, Bangkok/Melbourne, Cambodia, 2Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, 3Centre for Biomedical Research, Burnet Institute, Melbourne, Australia, 4The National Center for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia, 5Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University/Centre for Biomedical Research, Burnet Institute, Bangkok, Thailand, 6Malaria Consortium Asia, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, 7Medical Anthropology Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium/School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan/Partners for Applied Social Sciences (PASS) International, Antwerp/Japan, Belgium, 8College of Public Health, Medical and Veterinary Sciences; Division of Tropical Health and Medicine; James Cook University, Townsville, Queensland, Australia/The University of Queensland School of Public Health, Herston, Queensland, Australia Disclosures S.E. Canavati: None. Abstract Background. Village Malaria Workers (VMWs) and Mobile Malaria Workers (MMWs) are a critical component of Cambodia’s national strategy to eliminate P. falciparum malaria by 2025. Since 2004, VMWs have been providing malaria diagnosis through the use of Rapid Diagnostic Tests (RDTs), and free-of-charge Artemisinin-based Combination Therapies (ACTs) in villages more than 5 kilometres away from the closest health facility. This study aimed to assess the job performance of VMWs/MMWs, and identify challenges they face, which may impede elimination efforts. Methods. A mixed-methods assessment was conducted in five provinces of western Cambodia. 185 VMW/MMW participants were surveyed using a structured questionnaire. Qualitative data was gathered through a total of 60 Focus Group Discussions (FGDs) and 65 In-depth Interviews (IDIs). Data triangulation of the qualitative and quantitative data was used during analysis. Results. Overall, VMWs/MMWs met or exceeded the expected performance levels (80%). Nevertheless, some performance gaps were identified. Misconceptions regarding malaria transmission and prevention were found among workers. The recommended approach for malaria treatment, Directly Observed Treatment (DOT), had low implementation rates. Stock outs, difficulties in reaching out to Migrant and Mobile Populations (MMPs), insufficient means of transportation and dwindling worker satisfaction also affected job performance. Discussion. VMW/MMW job performance must be increased from 80% to 100% in order to achieve elimination. In order to do this, it is recommended for the national malaria program to eliminate worker malaria knowledge gaps. Barriers to DOT implementation and health system failures also need to be addressed. The VMW programme should be expanded on several fronts in order to tackle remaining performance gaps. Findings from this evaluation are useful to inform the planning of future activities of the programme and to improve the effectiveness of interventions in a context where artemisinin drug resistance is a significant public health issue.
http://www.abstractsonline.com/pp8/#!/4114/presentation/4500
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