Poster Presentation First Malaria World Congress 2018

Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015 (#330)

Nay Yi Yi Linn 1 , Soundappan Kathirvel , Mrilnalini Das , Badri Thapa , Md Mushfiqur Rahman , Thae Maung Maung , Aye Mon Mon Kyaw , Aung Thi , Zaw Lin
  1. Vector Borne Disease Control Unit, NAY PYI TAW, Myanmar

Background-Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS) in Myanamr. This country-wide analysis aimed to assess and compare the accessibility to- and quality of malaria care between VHV and BHS in Myanmar. 

Methods-This retrospective cohort study used record review of routinely collected programme data. All patients with undifferentiated fever screened and diagnosed for malaria in January-December 2015 by VHV and BHS under National Programme, Myanmar were studied. Unadjusted and adjusted prevalence ratios (aPR) were calculated to assess the effect of VHV/BHS on receipt of treatment by patients.

Results-Of 978,735 undifferentiated fever patients screened in 2015, 11% (107,617) were found malaria positive and it was similar (11%) in both screened by VHV (300,90/270,155) and BHS (77,527/708,580). Higher proportion of children aged 5-14 years (22%, 17%) and females (44%, 42%) with fever were screened for malaria by VHV compared to BHS. However, the same for children aged <5 years was 2% lower in VHV group compared to BHS. The proportion of malaria cases a) received treatment was 97% and 95%; treatment initiation within 24 hours of fever was 45% and 35%; and complete treatment provision was 81% and 88% respectively in VHV and BHS. After adjustment for potential confounders, patients with malaria provided care by VHV had 1.65 times higher chance of receiving treatment compared to BHS [aPR (95% Confidence-Interval)-.65 (1.54,1.78)].

Conclusion-The VHV were more accessible to children and women than BHS in providing malaria screening services. The malaria treatment services provided by VHV were better than by BHS except for delivering complete treatment. Further qualitative research to explore and address the challenges on initiation and delivering complete treatment by VHV and cost effectiveness studies on integration of VHV in routine health system are needed.