The reception of village malaria workers in rural Cambodia: knowledge, perceptions, and preferences in user communities

The recently concluded Global Health Systems Research Symposium in Cape Town featured a number of abstracts that touched directly or indirectly on malaria. Malaria services and movement toward malaria elimination cannot be achieved in a country without a strong health system that involves both communities, program staff and policy makers.

globalsymposium_logosBelow is an abstract by Marco Liverani, Ra Sok, Daro Kim, Panarith Nou, Sokhan Nguon, Chea Nguon, Shunmay Yeung of the London School of Hygiene and Tropical Medicine, UK, Partners for Development, Cambodia and Ministry of Health, Cambodia on malaria village health workers in Cambodia.

“Despite sustained efforts to strengthen the health system and significant progress, Cambodia still suffers from critical shortages of health professionals and inequities in the distribution of health services. This problem is particularly acute in remote areas, where the incidence of infectious diseases such as malaria and typhoid fever is higher, where access to health facilities may be limited by environmental barriers, and where poor communities bear the greatest economic burden of illness.

Village Malaria Worker courtesy of WHO: http://who.int/malaria/areas/greater_mekong/cambodia-frontline-heroes/en/

Village Malaria Worker courtesy of WHO: http://who.int/malaria/areas/greater_mekong/cambodia-frontline-heroes/en/

“Over the past decade, the deployment of lay members of the community to provide basic medical services amongst the most vulnerable populations has been one of the key interventions to address this problem.

“We conducted a qualitative study to examine the reception and impact of the Village Malaria Workers (VMW) programme in Cambodia, a community-based intervention to support the management of malaria cases and childhood illnesses.

“Methods included observations and in-depth interviews (n=80) in user communities. A thematic question guide with open-ended questions was used for the interviews. Thematic content analysis was then conducted to explore factors that may promote or discourage service utilisation.

“Many respondents thought that VMWs can deliver appropriate medical care and services, but some expressed a preference for private providers as these were seen to offer more comprehensive and qualified health care. Many respondents had inadequate awareness of VMWs and the range of services they provide.”

“Findings from our study point to the need for innovative communication strategies to increase the utilisation of VMWs. We argue that investment in symbols and visual communication tools are required to promote the visibility, status, and identity of health volunteers in user communities, also given current policy trends – in and outside Cambodia – towards an increasing use of community workers to perform roles and tasks that are conventionally associated with health professionals.

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