Drama as a community engagement strategy for malaria in rural Cambodia

Abstract

Background: Countries in Southeast Asia are working to eliminate multidrug-resistant falciparum malaria, a major cause of mortality in tropical regions. Malaria is declining but transmission persists in many rural areas and among forest workers and isolated populations. In these remote communities, conventional health services and education are limited. Mobilising and educating these populations require new approaches as many people are illiterate and do not attend village meetings. This article describes a qualitative study to assess the feasibility of a drama project as a community engagement strategy. Methods: A drama project was conducted in twenty villages in Cambodia with three key messages: to use insecticide-treated bednets and repellents, to get early diagnosis and treatment, and to learn about risks of forest-acquired malaria. Qualitative interviews were conducted with the drama team members, village malaria workers, local health staffs and villagers, to explore the feasibility of using drama to engage the community and the associated challenges. Results: 29 people were interviewed, which included 18 semi-structured interviews and one focus group discussion. Analysis of the interviews resulted in development of the following seven themes: i) exposure to malaria and engagement activities, ii) readiness and barriers to participation, iii) understanding and learning about malaria using drama, iv) entertainment value and engagement method preferences, v) challenges to community engagement, vi) future participation and vii) sustainability. The event saw a very positive response, with an encouraging average participation rate of 66%. The project faced several challenges including logistic problems, rescheduling due to raining season, and time- and budget-constraints. Conclusions: Our evaluation demonstrated that the drama project was feasible in promoting awareness and understanding of malaria prevention and control. Audience members perceived drama as entertaining and as the preferred choice of engagement activity. Participatory drama could be considered as part of the community engagement for malaria elimination.

Evaluation of the forum theatre approach for public engagement around antibiotic use in Myanmar

“…Public engagement activities have not been practised widely in Myanmar to date [22]. Drama has been used in neighbouring countries for engagement activities although not employing the forum theatre technique [23][24][25][26].…”

Ethics and Antimalarial Drug Resistance

“… Engaging with affected communities in creative and sensitive ways . Some work has already been conducted to engage forest workers, minority groups and mobile populations, and much more is needed (Lim et al 2017 ). This will improve understanding of the science behind malaria and malaria elimination and will facilitate interventions such as MDAs and MSATs .…”

Use of photovoice to explore the potential role of youth in contributing to maternal health in rural Wakiso district, Uganda

“…The importance of these avenues in MH education and promotion have been acknowledged in previous studies [40][41][42] and create great possibilities for youth engagement in communities. Use of drama for health promotion has been found to have the advantage of being entertaining as well as conveying health messages 43 and could be explored further in community health initiatives. In addition to drama, it is important for youth to utilise other existing avenues that bring many people together to communicate health messages.…”