In Burma, the USAID | PMI Control and Prevention of Malaria Project (CAP-Malaria) is strengthening routine malaria control activities in selected townships along the Thai-Burma border where there is high malaria burden and drug resistance to reduce malaria morbidity and mortality and to contribute toward the containment of artemisinin-resistant malaria. As these areas are remote and have weak infrastructure, CAP-Malaria emphasizes community engagement by strengthening the capacity of community-level malaria workers and volunteers. Through training and supportive supervision, and by fostering linkages with the public sector and other local stakeholders, village malaria workers (VMWs) have been trained and equipped to deliver comprehensive malaria control interventions such as distribution of insecticide-treated bed nets, early diagnosis, and prompt treatment.
In Kayin State, some villages in the Hlaing Bwe Township are located in hard to reach conflict areas and are not covered by the government’s Basic Health Services (BHS) program. In addition to the remote location, the villagers didn’t have trust in the government staff nor the services provided by BHS. Therefore, besides the high transportation costs, the government health care staff were unable to go to these villages as it was hard to build trust with the villagers and village leaders.
Since May 2014, CAP-Malaria has been providing malaria services in Noe Doe, one of the villages in Hlaing Bwe Township, including implementation of a referral system, health education through interpersonal communication, malaria video shows, case management and school malaria activities. In Noe Doe, CAP-Malaria trained and empowered a village malaria worker and two community health groups and, in less than a year, was able to build trust with the villagers and improve the villagers hope for healthier lives.
CAP-Malaria approached BHS staff to work in collaboration to provide integrated health services in Noe Doe. BHS staff agreed to provide measles, mumps, and rubella (MMR) immunizations for the villagers and, alongside CAP-Malaria, they were able to advocate without difficulty for villagers to participate in MMR vaccinations. Now, BHS staff regularly visit Noe Doe village as a joint activity with CAP-Malaria. CAP-Malaria staff conduct school malaria activities and malaria video shows while BHS staff provide immunization for all children up to fifteen years of age. The village leaders now welcome the immunization program and help with community mobilization. Villagers from hard to reach areas receive health awareness and services for both malaria and other preventable diseases thanks to the efforts of CAP-Malaria staff.
One of the villagers from Noe Doe stated, “As my village is located in an area of conflict, we are not covered by government services. I didn’t see any kind of advocacy or negotiation with village authorities for immunization programs for our children. We had to go to the Thailand-Burma border across the Thaung Yin River if we wanted to get immunizations. Most of the villagers were unable to go and missed receiving vaccinations during their childhood. Now, we are not only getting awareness and services for malaria but also for other health services by government staff through the help of CAP-Malaria. We are so delighted and are very grateful to CAP-Malaria for this.”