Challenges encountered among community-delivered malaria volunteers in Greater Mekong Sub-region for malaria elimination: a systematic review

Authors

  • Nanda L. Shwe World Health Organization, Nay Pyi Taw, Myanmar
  • Thein Hlaing Department of Public Health, Ministry of Health, Pyay District, Bago Region, Myanmar
  • Kyaw M. Tun Department of Health and Social Sciences, STI Myanmar University, Yangon, Myanmar

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20220872

Keywords:

Challenges, Community-delivered malaria volunteers, Malaria elimination and GMS

Abstract

In the Greater Mekong Sub-region (GMS) countries, community-delivered malaria volunteers (CDMVs) have been serving a vital role in providing primary preventive and curative services of malaria in the uncovered areas, but they have encountered different challenges. The main purpose of this systematic review was to determine the CDMVs’ challenges in malaria elimination settings of the GMS. A review team applied MEDLINE and PubMed, Google Scholar, and Myanmar Health Sciences Research Journal as major databases and Boolean operators as the focus search for selecting a final set of 46 English studies designed with qualitative and quantitative, and published in 2010 and after. The service qualities of CDMVs were affected by different challenges: motivational challenges (lack of incentive pay, supervision, shortage of malaria supply and inadequate training), community acceptance challenges (negative comments and less preference of community, unawareness of the CDMVs' roles, and inappropriate care of traditional healers), technical challenges (unsatisfactory knowledge and practices, complexities of reporting formats and applications), communication and transportation challenges (lack of electricity and Internet, inapplicability of transportation aids and poor road infrastructure), safety challenges (testing blood with unsafe technique), financial and logistic supply challenges (lack of supply for additional costs, and interruption of malaria ‘supply’) challenges in malaria management (difficulties in managing the patients with mixed malaria, invalid RDT results and severe patients). This review recommends that more research on the community malaria services should be invited and the malaria programmers from each GMS country should establish more perfect volunteer policies for eliminating the CDMVs’ challenges.

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References

World Health Organization. World Malaria Report 2020: 20 years of global progress and challenges. Geneva, Switzerland. 2020. Available at: https://www.who.int/publications-detail-redirect/ 9789240015791. Accessed on 21 October 2021.

World Health Organization. Countries of the Greater Mekong ready for the "last mile" of malaria elimination. Geneva, Switzerland. 2020. Available at: https://iris.who.int/handle/10665/64049. Accessed on 21 October 2021.

Cui L, Yan G, Sattabongkot J, Cao Y, Chen B, Chen X, et al. Malaria in the Greater Mekong Subregion: heterogeneity and complexity. Acta Trop. 2012;121(3):227-39.

Kyaw SS, Drake T, Thi A, Kyaw MP, Hlaing T, Smithuis FM, et al. Malaria community health workers in Myanmar: a cost analysis. Malaria J. 2016;15(41):1-7.

The CDI Study Group. Community-directed interventions for priority health problems in Africa: results of a multi-country study. Bulletin World Health Organization. 2009;88:481-60.

Barros AJD, Ronsmans C, Axelson H, Loaiza E, Bertoldi AD, Franca GVA, et al. Equity in maternal, newborn, and child health interventions in Countdown to 2015: A retrospective review of survey data from 54 countries'. The Lancet. 2012;379(9822):1225-33.

Black RE, Levin C, Walker N, Chou D, Liu L, Temmerman M; DCP3 RMNCH Authors Group. Reproductive, maternal, newborn, and child health: key messages from Disease Control Priorities 3rd Edition. Lancet. 2016;388(10061):2811-24.

Aung PL, Silawan T, Rawiworrakul T, Min M. Perceived role and its enhancing factors among the village health volunteers regarding malaria control in rural Myanmar. Indian J Public Health. 2021;62(1):10-4,

Canavati SE, Lawpoolsri S, Quintero CE, Nguon C, Ly P, Pukrittayakamee S, et al. Village malaria worker performance key to the elimination of artemisinin-resistant malaria: A Western Cambodia health system assessment. Malaria J. 2016;15(282):1-15.

Cox J, Soley LD, Bunkea T, Sovannaroth S, Ty KS, Ngak S, et al. Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia. Malaria J. 2014;13(282):1-12.

Ngor P, White LJ, Chalk J, Lubell Y, Favede C, Cheah PY, et al. Smartphones for community health in rural Cambodia: A feasibility study. Welcome Open Res. 2018;3(69):1-13.

Sato Y, Pongvongsa T, Nonaka D, Kounnavong S, Nansounthavong P, Moji K, et al. Village health volunteers' social capital related to their performance in Lao People's Democratic Republic: a cross-sectional study. BMC Health Serv Res. 2014;14(123):1-9.

Sirilak S, Okanurak K, Wattanagoon Y, Chatchaiyalerk S, Tornee S, Siri S. Community participation of cross-border migrants for primary health care in Thailand. Health Policy Plan. 2013;28(6):658-64.

Oo WH, Hoban E, Gold L, Than KK, La T, Thi A, et al. Optimizing Myanmar's community-delivered malaria volunteer model: a qualitative study of stakeholders' perspective. Malaria J. 2021;20(79):1-13.

Lwin MM, Sudhinaraset M, San KA, Aung T. Improving malaria knowledge and practices in rural Myanmar through a village health worker intervention: a cross-sectional study. Malaria J. 2014;13(5):1-5.

Yasuoka J, Poudel KC, Tandukar KP, Nguon C, Ly P, Socheat D, et al. Assessing the quality of service of village malaria workers to strengthen community-based malaria control in Cambodia. Malaria J. 2010;9:2-11.

Hasegawa A, Yasuoka J, Ly Po, Nguon C, Jimba M. Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers. Malaria J. 2013;12(292):1-12.

Sudhinaraset M, Briegleb C, Aung M, Khin HSS, Aung T. Motivation and challenges for use of malaria rapid diagnostic tests among informal providers in Myanmar: a qualitative study. Malaria J. 2015;14(61):1-11.

Canavati SE, Quintero CE, Lawford HLS, Yok S, Lek D, Richards JS, et al. High mobility, low access thwarts interventions among seasonal workers in the Greater Mekong Sub-region: lessons from the malaria containment project'. Malaria J. 2016;15(434):1-13.

Minn PW, Shewade HD, Kyaw NTT, Phyo KH, Linn NYY, Min MS, et al. Quality of Malaria Treatment Provided under 'Better Health Together' Project in Ethnic Communities of Myanmar: How Are We Performing?' Trop Med Infect Dis. 2019;4(4):1-14.

Kajeechiwa L, Thwin MM, Nosten S, Tun SW, Parker D, Seidlein LV, et al. Community engagement for the rapid elimination of malaria: the case of Kayin State, Myanmar. Welcome Open Res. 2017;2(59):1-14.

McLean ARD, Wai HP, Thu AM, Khant ZS, Indrasuta C, Ashley EA, et al. Malaria elimination in remote communities requires integration of malaria control activities into general health care: an observational study and interrupted time series analysis in Myanmar'. BMC Med. 2018;16(1):1-10.

Liverani M, Sok NR, Kim D, Nou P, Nguon S, et al. Improving access to health care amongst vulnerable populations: a qualitative study of village malaria workers in Kampot, Cambodia. BMC Health Serv Res. 2017;17(335):1-11.

Kunkel A, Nguon C, Iv S, Chhim S, Peov D, Kong P, et al. 'Choosing interventions to eliminate forest malaria: preliminary results of two operational research studies inside Cambodian forests'. Malaria J. 2021;20(51):1-13.

Phommanivong V, Thongkham K, Deyer G, Rene JP, Barennes H. An assessment of early diagnosis and treatment of malaria by village health volunteers in the Lao PDR. Malaria J. 2010;9(347):1-10.

Nyunt MH, Aye KM, Kyaw KT, Han SS, Aye TT, Wai KT, et al. Challenges encountered by local health volunteers in early diagnosis and prompt treatment of malaria in Myanmar artemisinin resistance containment zones. Malaria J. 2016;15(308):1-8.

Maung CN, Sein TT, Hlaing T, Okanurak K, Silawan T, Kaewkungwal J. Promoting community malaria control in rural Myanmar through an active community participation program using the participatory learning approach. Rural and Remote Health. 2016;17(2):1-14.

Aung T, Longfield K, Aye NM, San AK, Sutton TS, Montagu D, et al. Improving the quality of paediatric malaria diagnosis and treatment by rural providers in Myanmar: an evaluation of a training and support intervention. Malaria J. 2015;14(397):1-9.

Aung P, Pumpaibool T, Soe TN, Kyaw MP. Feasibility of Real-Time Mobile Phone Case Notification by Village Malaria Workers in Rural Myanmar: A mixed Methods Study'. Global J Health Sci. 2019;10(1):103-12.

Than WP, Nyein A, Thi A. Assessment of Knowledge and Performance of Village Health Volunteers after Expanding Their Responsibilities in Bago Region, Myanmar, 2017'. Outbreak, Surveillance, Investigation and Response (OSIR) J. 2020;13(4):154-9.

Oo WH, Hoban E, Gold L, Than KK, La T, Thi A, et al. Community demand for comprehensive primary health care from malaria volunteers in South-East Myanmar: a qualitative study'. Malaria J. 2021;20(19):1-12.

Thapa B, Thi A, Than WP, Win KM, Khine SK. Myanmar Continues to Curb Malaria amid Coronavirus Disease-2019 Crisis. 2019.

Linn NYY, Kathirvel S, Das Mrinalini, Thapa B, Rahman M, Maung TM, et al. Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015. Malaria J. 2018;17:242.

Kasteng F, Settumba S, Källander K, Vassall A, the inSCALE Study Group. Valuing the work of unpaid community health workers and exploring the incentives to volunteering in rural Africa. Health Policy and Planning. 2016;31(2):205-16.

Winn LK, Lesser A, Menya D, Baumgartner JN, Kirui KJ, Saran I, et al. Motivation and satisfaction among community health workers administering rapid diagnostic tests for malaria in Western Kenya. J Glob Health. 2018;8(1):010401.

Vizeshfar F, Momennasab M, Yektatalab S, Iman MT. Challenges faced by health volunteers in comprehensive health centers in the southwest of Iran: A qualitative content analysis. J Med Life. 2018;11(1):62-8.

Aseyo RE, Mumma J, Scott K, Nelima D, Davis E, Baker KK, et al. Realities and experiences of community health volunteers as agents for behaviour change: evidence from an informal urban settlement in Kisumu, Kenya. Hum Resour Health. 2018;16(1):53.

Olapeju B, Adams C, Hunter G, Wilson S, Simpson J, Mitchum L, et al. Malaria prevention and care seeking among gold miners in Guyana. PLoS One. 2020;15(12):e0244454.

Das A, Gupta RD, Friedman J, Pradhan MM, Mohapatra CC, Sandhibigraha D. Community perceptions on malaria and care-seeking practices in endemic Indian settings: policy implications for the malaria control programme. Malar J. 2013;12:39.

Ochieng BM, Kaseje DO, Mala SJ, Mumbo HM, Aila FO, Odera O. Motivational Drivers for Non-Skilled Kenyan Community Health Volunteers”. Int J Asian Social Sci. 2012;2(9):1477-83.

Blanas, DA, Ndiaye Y, Nichols K, Jensen A, Siddiqui A, Hennig N. Barriers to community case management of malaria in Saraya, Senegal: training, and supply chains. Malaria J. 2013;12(95):1-7.

Kweku M, Manu E, Amu H, Aku FY, Adjuik M, Tarkang EE, et al. Volunteer responsibilities, motivations and challenges in the implementation of the community-based health planning and services (CHPS) initiative in Ghana: qualitative evidence from two systems learning districts of the CHPS+ project'. BMC Health Serv Res. 2020;20(482).

Sudoi RK, Githinii S, Nyandigisi A, Muturi A, Snow RW, Zurovac D. The magnitude and trend of artemether-lumefantrine stock-outs at public health facilities in Kenya'. Malaria J. 2012;11(37):1-5.

Kangwana BB, Njogu J, Wasunna B, Kedenge SV, Memusi DN, Goodman CA, et al. Malaria drug shortages in Kenya: a major failure to provide access to effective treatment'. Am J Trop Med Hyg. 2009;80(5):737-8.

Marita EO, Gichuki R, Watulo E, Thiam S, Karanja S. Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya. J Infect Dev Ctries. 2021;15:897-903.

Banek K, Nankabirwa J, Maiteki-Sebuguzi C, DiLiberto D, Taaka L, Chandler CI, et al. Community case management of malaria: exploring support, capacity and motivation of community medicine distributors in Uganda. Health Policy Plan. 2015;30(4):451-61.

Elmardi KA, Malik EM, Abdelgadir T, Ali SH, Elsyed AH, Mudather MA, et al. Feasibility and acceptability of home-based management of malaria strategy adapted to Sudan's conditions using artemisinin-based combination therapy and rapid diagnostic test'. Malaria J. 2009;8(39):1-8.

Harvey SA, Jennings L, Chinyama M, Masaninga F, Mulholland K, Bell DR, et al. Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training'. Malaria J. 2008;7(160):1-12.

MacDonald R. 'Save Somalia'. Lancet. 2008;373(2184).

Ndiaye Y, Ndiaye JLA, Cisse B, Blanas D, Bassene J, Manga IA, et al. Community case management in malaria: review and perspectives after four years of operational experience in Saraya district, south-east Senegal. Malaria J. 2013;12(240).

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Published

2022-03-25

How to Cite

Shwe, N. L., Hlaing, T., & Tun, K. M. (2022). Challenges encountered among community-delivered malaria volunteers in Greater Mekong Sub-region for malaria elimination: a systematic review. International Journal Of Community Medicine And Public Health, 9(4), 1903–1913. https://doi.org/10.18203/2394-6040.ijcmph20220872

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Section

Systematic Reviews