If we are to achieve universal coverage – a crucial step along the pathway to malaria elimination – we must be sure that all at risk populations are reached.
IRIN news gives us reasons to pause.Â Reporting on Vietnam, IRIN found that, “Maternal mortality rates vary widely across the country. In Cao Bang province, with a 98 percent ethnic minority population, there are 411 maternal deaths for every 100,000 live births, according to UNICEF. In Binh Duong province, near Ho Chi Minh City, the rate is less than one-tenth of that.”
In remote mountainous areas IRIN notes that, “Minorities such as the Hâ€™Mong mostly still give birth at home, and are far less likely to access healthcare, especially antenatal care, health specialists say.” An important part of antenatal care is prevention and treatment of malaria.Â Besides geographical access, minorities also have financial access problems since they are often poorer than the general population.
Minority access affects many countries and health problems. We found that in southwestern Nigeria, migrant Fulani populations were less likely to get childhood immunizations than their sedentary counterparts. The Fulani there depend more on private health providers to avoid perceived discrimination at local government health services. The settlements of these cattle herding peoples were often overlooked during guinea worm surveillance activities.
Specific to malaria, Dysoley and colleagues found that ethnic minorities working in the forests of Cambodia, while more susceptible to malaria, have been neglected in the past. Ahmed found in Balgladesh differential health and health-seeking behaviors among ethnic groups for illnesses including malaria where Bangalis were more likely to seek qualified allopaths as providers than did ethnic minorities.
Timely and equitable access to effective malaria interventions for all peoples in endemic areas is the only way that malaria can be eliminated.