Raks Thai Foundation has implemented a number of initiatives aimed at engaging and empowering communities to take control of their health outcomes. In 2016, 12 volunteers in provinces bordering Cambodia and Laos facilitated 2,918 tests within their respective communities and at border crossings, with a 2% confirmed-positive rate. These volunteers also conducted health education sessions on basic transmission and prevention, and distributed long-lasting insecticidal nets.
As Thailand entered the elimination phase, case detection became more difficult; requiring health workers to think creatively and prioritize populations most at-risk. The majority of remaining cases have shifted to migrant and mobile populations (MMP), particularly forest-goers. Although Thailand provides free testing and treatment, remote locations, a health workforce not sensitive to varying needs or languages, and a fear of deportation for undocumented migrants, often prevents MMPs from accessing health services.
Raks Thai continues to implement community and worksite-based activities, but is also prioritizing forest and border areas that contain Thailand’s highest malaria incidence and see large numbers of migrants utilizing irregular migration pathways. We are scaling-up our volunteer network by recruiting additional migrant volunteers from within forest-goer populations who are key to building trust, and ideal candidates to model positive health behaviors. These volunteers are trained using a comprehensive toolkit including modules on transmission, prevention, intensified case finding, behavioral change communication, and treatment. Equipped with checklists, IEC materials and LLIHNs, volunteers are incentivized to conduct health education sessions, facilitate testing of over 4000 suspected cases per year, and subsequently manage confirmed-positive cases throughout treatment according to national guidelines.
By engaging migrant volunteers from within MMPs most at-risk, particularly forest-goers, our activities build on their pre-existing knowledge of population movements, health literacy and health behaviors; reducing barriers to delivering health services and maximizing our contribution to malaria elimination in Thailand, and the Greater Mekong Subregion.