Internally displaced human resources for health: Villager health worker partnerships to scale up a malaria control programme in active conflict areas of eastern Burma

Abstract

Approaches to expand malaria control interventions in areas of active conflict are urgently needed. Despite international agreement regarding the imperative to control malaria in eastern Burma, there are currently no large-scale international malaria programmes operating in areas of active conflict. A local ethnic health department demonstrated that village health workers are capable of implementing malaria control interventions among internally displaced persons (IDPs). This paper describes how these internally displaced villagers facilitated rapid expansion of the programme. Clinic health workers received training in malaria diagnosis and treatment, vector control and education at training sites along the border. After returning to programme areas inside Burma, they trained villagers to perform an increasingly comprehensive set of interventions. This iterative training strategy to increase human resources for health permitted the programme to expand from 3000 IDPs in 2003 to nearly 40,000 in 2008. It was concluded that IDPs are capable of delivering essential malaria control interventions in areas of active conflict in eastern Burma. In addition, health workers in this area have the capacity to train community members to take on implementation of such interventions. This iterative strategy may provide a model to improve access to care in this population and in other conflict settings.

Community Health Workers in Low- and Middle-Income Countries: What Do We Know About Scaling Up and Sustainability?

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Scale-up of community-based malaria control can be achieved without degrading community health workers' service quality: the Village Malaria Worker project in Cambodia

“…Therefore, community health workers have come to receive much attention in promoting scale-up of disease control and achieving MDGs [10-12]. However, there is a massive global shortage and mal-distribution of health workers [13-15] and hence an urgent need of task shifting by making more efficient use of the existing cadres and to train new cadres to expand the health workforce [11,16,17].…”

Assessing local capacity to expand rural breast cancer screening and patient navigation: An iterative mixed-method tool

“…The rapid assessment process literature offered a more robust approach, by encouraging use of both qualitative and quantitative data. These “mixed-method” designs enable evaluators to account for changes in local settings and organizational context (Dick, Clarke, van Zyl, & Daniels, 2007; Jilcott, Ickes, Ammerman, & Myhre, 2010; Lee, Smith, Shwe Oo, Scharschmidt, Whichard, et al, 2009). Rapid assessment processes themselves are commonly iterative, both in sequence of methods and waves of data collection.…”