Promoting community knowledge and action for malaria control in rural Cambodia: potential contributions of Village Malaria Workers

Abstract

BackgroundCambodia has been investing in Village Malaria Workers (VMWs) to improve malaria case management in rural areas. This study assessed the quality of the VMWs’ services compared to those by a government-run health center from the perspective of community members. We focused on VMWs’ contribution to promote their action to control malaria. A community-based cross-sectional study was conducted in Kampot province in 2009. Interviews were conducted at every accessible household in a village with VMWs (n = 153) and a village with a health center (n = 159), using interviewer administered questionnaire. Preference of the interview was given to female household head. Multiple regression analyses were run to compare knowledge about malaria, preventive measures taken, and time before first malaria treatment between the two villages.FindingsThe villagers perceived the VMWs’ services equally as good as those provided by the health center. After controlling for confounding factors, the following indicators did not show any statistical significance between two villages: community members’ knowledge about malaria transmission (AOR = 0.60, 95% CI = 0.30-1.22) and government-recommended antimalarial (AOR = 0.55, 95% CI = 0.25-1.23), preventive measures taken (Beta = −0.191, p = 0.315), and time before the first treatment (Beta = 0.053, p = 0.721). However, knowledge about malaria symptoms was significantly lower in the village with VMWs than the village with a health center (AOR = 0.40, 95% CI = 0.19-0.83).ConclusionsVMWs played an equivalent role as the health center in promoting malaria knowledge, action, and effective case management. Although VMWs need to enhance community knowledge about malaria symptoms, the current government policy on VMWs is reasonable and should be expanded to other malaria endemic villages.

Caregivers’ treatment-seeking behaviour for children under age five in malaria-endemic areas of rural Myanmar: a cross-sectional study

“…Greater awareness about malaria and undertaking a broader range of preventive actions for malaria influence appropriate treatment-seeking behaviour. A study in Cambodia showed that early recognition of malaria symptoms is the first important step to treatment seeking [ 20 ]. In the present study, although caregivers were aware of malaria symptoms, about 50% were unaware that children under five and pregnant mothers are especially vulnerable to malaria.…”

“…A structured questionnaire was developed based on the WHO Malaria Indicator Survey tool [ 19 ] and relevant studies [ 20 – 23 ]. The questionnaire was first developed in English, translated into Myanmar language, and translated back into English by experts on public health and malaria in Myanmar.…”

“…Socio-economic and personal factors are known to influence treatment-seeking behaviour. The following were included as independent variables: participants’ age, sex [ 12 ], level of education, occupation [ 1 , 9 , 10 ], income [ 1 , 12 ], proximity to public health services [ 1 ], knowledge of malaria [ 9 ], prevention behaviour [ 20 ] and type of village (MV or NMV).…”

Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers

“…The sample size of caregiver participants was calculated using Power and Precision software (Biostat, Englewood, New Jersey, USA), based on 40% VMW service utilization in M villages [28] and the assumption of an approximately 10% higher utilization in M+C villages, with alpha set at 0.05 and 80% power. This resulted in a minimum sample size of 388 caregivers to be surveyed per service type.…”

“…The VMW project has improved knowledge and practices of VMWs to prevent malaria and to provide early diagnosis and treatment in remote malaria endemic villages [16,27]. VMWs can now provide malaria control services comparable in quality to those of the local health facilities [28]. In March 2011, the government of Cambodia formally committed itself to eliminate malaria by the year 2025, identifying the VMW project as one of the key strategies to meet that goal [4].…”