Optimizing Myanmar's community-delivered malaria volunteer model: a qualitative study of stakeholders' perspectives.
Optimizing Myanmar's community-delivered malaria volunteer model: a qualitative study of stakeholders' perspectives.
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DOI：
10.1186/s12936-021-03612-6
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发表时间：
2021-02-08
期刊：
影响因子：
3
通讯作者：
Fowkes FJI
中科院分区：
文献类型：
--
作者：
Win Han Oo;Hoban E;Gold L;Kyu Kyu Than;Thazin La;Aung Thi;Fowkes FJI
随着大湄公河次区域疟疾防治政策由控制向消除转变，疟疾负担下降，疟疾志愿者的积极性和社会作用下降。为了解决这一公共卫生问题，缅甸疟疾志愿人员的作用和责任已转变为综合社区疟疾志愿人员，包括将另外五种疾病（登革热、淋巴丝虫病、结核病、艾滋病毒/艾滋病和麻风病）的活动纳入其目前的活动。然而，这一转变并不是以证据为基础的，也没有考虑到不同利益攸关方的投入。因此，进行了定性利益攸关方协商，以优化缅甸今后的疟疾志愿人员模式。对缅甸卫生和体育部和疟疾执行伙伴的主要卫生利益攸关方进行了半结构化访谈，以了解他们对社区提供的疟疾模式的看法。采用定性描述方法探讨利益攸关方在决策和方案执行方面的经验。在访谈过程中使用了访谈主题指南，并进行了归纳专题数据分析。虽然综合监测车辆成功地在社区提供了疟疾服务，但利益攸关方认为综合监测车辆模式并非最佳模式，并建议在许多方面需要改进，包括更好地培训、监督、支持和基本保健工作人员对综合监测车辆的认可。各利益攸关方认为，更新后的国际MV模式可大大有助于在缅甸实现消灭疟疾和普及保健。鉴于社区对志愿人员提供非疟疾治疗服务的需求很高，必须认真制定综合志愿服务包，使其在消除疟疾方案中发挥效力，并在缅甸实现全民医保的道路上作出贡献，但又不损害社区。一个基于证据的，社区提供的和首选的模式，也是卫生部接受的，尚未开发，以有效地促进实现疟疾消除和UHC目标，到2030年在缅甸。
In parallel with the change of malaria policy from control to elimination and declines in the malaria burden in Greater Mekong Sub-region, the motivation and social role of malaria volunteers has declined. To address this public health problem, in Myanmar, the role and responsibilities of malaria volunteers have been transformed into integrated community malaria volunteers (ICMV), that includes the integration of activities for five additional diseases (dengue, lymphatic filariasis, tuberculosis, HIV/AIDS and leprosy) into their current activities. However, this transformation was not evidence-based and did not consider inputs of different stakeholders. Therefore, qualitative stakeholder consultations were performed to optimize future malaria volunteer models in Myanmar. Semi-structured interviews were conducted with key health stakeholders from the Myanmar Ministry of Health and Sports (MoHS) and malaria implementing partners to obtain their perspectives on community-delivered malaria models. A qualitative descriptive approach was used to explore the experiences of the stakeholders in policymaking and programme implementation. Interview topic guides were used during the interviews and inductive thematic data analysis was performed. While ICMVs successfully provided malaria services in the community, the stakeholders considered the ICMV model as not optimal and suggested that many aspects needed to be improved including better training, supervision, support, and basic health staff’s recognition for ICMVs. Stakeholders believe that the upgraded ICMV model could contribute significantly to achieving malaria elimination and universal health care in Myanmar. In the context of high community demand for non-malaria treatment services from volunteers, the integrated volunteer service package must be developed carefully in order to make it effective in malaria elimination programme and to contribute in Myanmar’s pathway to universal health coverage (UHC), but without harming the community. An evidenced-based, community-delivered and preferred model, that is also accepted by the MoHS, is yet to be developed to effectively contribute to achieving malaria elimination and UHC goals in Myanmar by 2030.
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3
作者：
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通讯作者：
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DOI：
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