Promoting community malaria control in rural Myanmar through an active community participation program using the participatory learning approach

Abstract

Promoting community malaria control in rural Myanmar through an active community participation program using the participatory learning approach Rural and Remote Health 17: 4130. (Online) 2017 Available: http://www.rrh.org.au A B S T R A C TIntroduction: Malaria is prevalent in more than 80% of townships in Myanmar. The National Malaria Control Programme (NMCP) has been implementing community-based malaria control programs nationwide. However, these programs are mostly developed and directed by health authorities, while communities are passively involved. This study aimed to increase community participation in malaria control and promote community malaria control knowledge and practice in rural Myanmar. Methods: A community-based study, which employed a mixed method approach, collecting data quantitatively and qualitatively, was conducted in two rural villages. The study implemented an active community participation program (ACPP) using the participatory learning approach in a village (ACPP village) but only routine malaria control was given in another village (non-ACPP village). All households with 142 and 96 household representatives from ACPP and non-ACPP villages participated in baseline and endline surveys. The ACPP was evaluated by process and outcome indicators. A spider gram analysis using five process indicators was applied to evaluate the process of the ACPP. Community participation status in malaria control activities and level of community malaria knowledge and practice were determined as outcomes of the ACPP. Results: The spider gram analysis showed that three indicators (needs assessment and planning, leadership and resource mobilization) gained a score of 4, the organization indicator a score of 5 and the management and evaluation indicator a score of 3. The outcome indicators of the program at 6 months showed that the community participation in malaria control activities in the © CN Maung, TT Sein, T Hlaing, K Okanurak, T Silawan, J Kaewkungwal, 2017. A A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 ACPP village had significantly increased (6.9% to 49.3%) (p<0.001). The program promoted community malaria control knowledge and practice in the ACPP village. The mean scores of knowledge, perception, preventive behavior and treatment-seeking behavior were increased significantly, from 3.0 to 5.9 (p<0.001), 20.1 to 21.0 (p<0.001), 3.4 to 4.2 (p<0.001) and 3.1 to 5.6 (p<0.001), respectively. However, no significant change of outcome indicators was found in the non-ACPP village.Conclusions: The ACPP implemented by community volunteers using the participatory learning approach was feasible in community-based malaria control. This study suggests several features in the ACPP model that may be useful strategies for the implementation of the current NMCP programs in similar rural settings; however, the effect of the ACPP over a longer period to ascertain the impact of such community participation has yet to be further studied.

Community engagement approaches for malaria prevention, control and elimination: a scoping review

“…Using the World Bank classification of countries by regions (online supplemental figure 2a), the majority of the studies were conducted in SSA (n=46)17 30–72 (table 1) followed by EAP (n=24)14 73–95 (table 2), SEA (n=3),96–98 and LAC (n=2)91 99 regions (table 3). More than half of the SSA studies were conducted in three countries: Uganda (n=12);34 51–56 58–61 63 Kenya (n=8);30 32 41 46 62 64 66 69 and Malawi (n=5) 17 49 50 68 70 72.…”

“…More than half of the SSA studies were conducted in three countries: Uganda (n=12);34 51–56 58–61 63 Kenya (n=8);30 32 41 46 62 64 66 69 and Malawi (n=5) 17 49 50 68 70 72. Similarly, two-thirds of the EAP studies were conducted in Myanmar (n=10)78 80 81 86 88 89 91 93–95 and Cambodia (n=7) 74–76 82 83 87 90. The study designs were: qualitative studies (n=25);17 30 35 39 46 49–51 59–61 63 66 73 74 76 80 82 87 89 91 93 94 99 100 quantitative studies (n=21);14 33 36 38 41 42 44 45 48 62 64 65 67 69 72 78 83–85 96 97 and mixed methods studies (n=21) 32 34 37 40 43 47 52–56 58 70 71 75 86 88 90 95 98 101.…”

A participatory approach to address within-country cross-border Malaria: the case of Menoreh Hills in Java, Indonesia

“…Our ndings suggest that di culties of cross-border malaria control in within-country settings are similar to challenges encountered in inter-country settings. Different program capacities, people mobility across borders, lack of joint planning and coordination, and inadequate cross-border surveillance and response were among the main themes identi ed [26][27][28][29]. Likewise, solutions enumerated by stakeholders were also identical to those suggested for international cross-border settings [29].…”

Knowledge mobilization in bridging patient‐practitioner‐researcher boundaries: A systematic integrative review

“…The twin benefits of raising awareness and direct patient outcomes are reported in intervention-based studies. These are demonstrated in raising awareness and education in communities (Dongre et al, 2009;Younes et al, 2014) and in direct effects of KMb, such as reduced neonatal mortality (Eriksson et al, 2016), improved maternal care (Ensor et al, 2014) and reduction in cases of malaria (Muang et al, 2017;Mukabana et al, 2006). Overall, from a KMb perspective, the context and meaning of 'impact' is shaped by the purpose of each study, wherein producing quantifiable outcomes is not a priority.…”