Poster Presentation First Malaria World Congress 2018

Leveraging lessons learned from malaria service delivery programs to expand integrated community case management in remote areas of Papua New Guinea (#288)

Carrie Madison Gheen 1 , Shannon McVey 1
  1. Population Services International, Gordons, NCD, Papua New Guinea

Access to care remains a challenge in rural PNG as many aidposts are closed.  The Home-based Management of Malaria (HMM) program attempted to bridge the malaria service gap in three provinces (East Sepik, East New Britain and Sandaun) using a network of volunteer community-based distributors (CBD).  Provinces were selected based on malaria incidence, access to health services and buy-in from the Provincial Health Administration (PHA). PHAs had to ensure CBDs were linked to a health facility. The HMM program covered a population of 616,559 with 1,000 active CBDs.

PSI conducted a household survey in 2016, the first of its kind PNG, to compare treatment seeking behaviour for fever among caregivers for children in HMM and non-HMM communities. To explore potential for iCCM, the study assessed knowledge and treatment seeking practices for diarrhoea and pneumonia. 13 qualitative interviews were conducted with CBDs to understand their experience with HMM.

Survey results indicate positive impact of HMM in rural provinces. In Sandaun, choice of CBDs correlated with fewer caregivers first treating at home and CBDs were first choice of external care (34.3%). In East Sepik and Sandaun, CBDs were the preferred source of care by caregivers because they were ‘close by or easy to reach’ (p<0.001). Results in East New Britain were different, increased use of hospitals and less use of CBDs. The results found a high prevalence of diarrhoea, but only 7% of caregivers knew correct treatment. Pneumonia was less reported and understood– 50% of caregivers could not name the symptoms. Interviews with CBDs indicated a positive perception of HMM and their desire to continue.

Given the success of HMM, there is possibility to expand to iCCM. Discussion on how to ensure continued quality should be considered as well as the operating model with the PHA to deepen integration into the public-sector.

  1. Kurumop SF, Tandrapah A, Hetzel MW, Siba PM, Mueller I & Pulford J. The Papua New Guinea National Malaria Control Program: Health facility Surveys, 2010-2106. Papua New Guinea Institute of Medical Research, Goroka, 2016.