Oral Presentation First Malaria World Congress 2018

Process of optimising the roles of integrated community malaria volunteers in malaria elimination-Myanmar experience (#52)

HTIN KYAW THU 1 , Min Min Thein 1 , Myo Set Aung 1
  1. Save the Children, Myanmar, Bahan Township, YANGON, Myanmar

Background: In Myanmar, malaria volunteers have played a vital role in stable reduction of confirmed malaria cases since 2012. In 2017, 78% of all confirmed malaria cases (n=76,770) were detected by over 15,000 trained community malaria volunteers. Volunteers have important role in service delivery and surveillance, especially in hard-to-reach areas where malaria cases in Myanmar are now most concentrated. As disease burden declines, maintaining volunteer motivation and relevance is vital to reach elimination. This session will focus on Myanmar’s experience in optimizing the roles of community malaria volunteers in the elimination setting.

The Process: As Myanmar moves towards elimination, malaria volunteers will continue their vital work providing diagnostic and treatment services, and distributing bed nets in hard-to-reach communities to promote universal access. In keeping with the National Malaria Elimination Plan, elimination activities will be implemented in low malaria transmission areas with manageable caseloads (less than 1 case per 1,000 populations). Volunteers deployed in these areas notify local authorities of confirmed malaria cases within 24 hours, triggering a cascade of surveillance activities. Given the vast geographic setting in Myanmar, user-friendly mobile applications are now being tested to get the real-time, case-based notification from volunteers. With proper training, supervision, and simplified tools, volunteers assist civil society organizations in case investigation, thus reducing the National Malaria Control Program’s workload, and helping address logistical, cultural, and resource barriers to go to the villages and investigate every notified case. Volunteer-facilitated Information can help the national program make timely decisions to interrupt transmission. To ensure long-term relevance, in addition to routine malaria services, volunteer services were expanded to include community mobilization, case finding and referral for common infectious diseases in the communities (tuberculosis, HIV, dengue, filariasis, and leprosy). By doing so, volunteers act as catalysts in malaria elimination and potentially other major infectious diseases, producing wider investment impact.

Challenges: Though these initiatives are expected to sustain volunteer motivation and build resilient community systems beyond the malaria elimination agenda, important challenges remain. Myanmar must manage limited financing beyond donor grants, complex coordination between public, private and community systems (both in-country and across the GMS region), and external factors such as armed conflicts to ensure successful implementation.