High mobility, low access thwarts interventions among seasonal workers in the Greater Mekong Sub-region: lessons from the malaria containment project View Full Text


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Article Info

DATE

2016-08-26

AUTHORS

Sara E. Canavati, Cesia E. Quintero, Harriet L. S. Lawford, Sovann Yok, Dysoley Lek, Jack S. Richards, Maxine Anne Whittaker

ABSTRACT

BACKGROUND: During the process of malaria elimination in the Greater Mekong Sub-region, mobile and migrant populations (MMPs) have been identified as the most at-risk demographic. An important sub-group of MMPs are seasonal workers, and this paper presents an evaluation of the reach and effectiveness of interventions tailored towards this group and was carried out as part of the Containment Project from 2009-11. METHODS: A mixed-methods study was conducted in Pailin Province in Western Cambodia. Three-hundred-and-four seasonal workers were surveyed using a structured questionnaire. Qualitative data were gathered through a total of eight focus group discussions and 14 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. RESULTS: High mobility and low access of the target population to the interventions, as well as lack of social and anthropological research that led to implementation oversights, resulted in under-exposure of seasonal workers to interventions. Consequently, their reach and impact were severely limited. Some services, particularly Mobile Malaria Workers, had the ability to significantly impact key factors, such as risky behaviours among those they did reach. Others, like Listening and Viewing Clubs and mass media campaigns, showed little impact. CONCLUSIONS: There is potential in two of the interventions assessed, but high mobility and inadequate exposure of seasonal workers to these interventions must be considered in the development and planning of future interventions to avoid investing in low-impact activities and ensure that all interventions perform according to their maximum potential. This will be critical in order for Cambodia to achieve its aim of malaria elimination. The lessons learned from this study can be extrapolated to other areas of health care in Cambodia and other countries in order to reduce the gap between healthcare provided to MMPs, especially seasonal workers, and to the general population. More... »

PAGES

434

References to SciGraph publications

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    31 schema:description BACKGROUND: During the process of malaria elimination in the Greater Mekong Sub-region, mobile and migrant populations (MMPs) have been identified as the most at-risk demographic. An important sub-group of MMPs are seasonal workers, and this paper presents an evaluation of the reach and effectiveness of interventions tailored towards this group and was carried out as part of the Containment Project from 2009-11. METHODS: A mixed-methods study was conducted in Pailin Province in Western Cambodia. Three-hundred-and-four seasonal workers were surveyed using a structured questionnaire. Qualitative data were gathered through a total of eight focus group discussions and 14 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. RESULTS: High mobility and low access of the target population to the interventions, as well as lack of social and anthropological research that led to implementation oversights, resulted in under-exposure of seasonal workers to interventions. Consequently, their reach and impact were severely limited. Some services, particularly Mobile Malaria Workers, had the ability to significantly impact key factors, such as risky behaviours among those they did reach. Others, like Listening and Viewing Clubs and mass media campaigns, showed little impact. CONCLUSIONS: There is potential in two of the interventions assessed, but high mobility and inadequate exposure of seasonal workers to these interventions must be considered in the development and planning of future interventions to avoid investing in low-impact activities and ensure that all interventions perform according to their maximum potential. This will be critical in order for Cambodia to achieve its aim of malaria elimination. The lessons learned from this study can be extrapolated to other areas of health care in Cambodia and other countries in order to reduce the gap between healthcare provided to MMPs, especially seasonal workers, and to the general population.
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    39 Greater Mekong Sub-region
    40 MMPs
    41 Mekong Sub-region
    42 Mobile Malaria Workers
    43 Pailin Province
    44 Province
    45 Viewing Clubs
    46 ability
    47 access
    48 access thwarts interventions
    49 activity
    50 aim
    51 analysis
    52 anthropological research
    53 area
    54 behavior
    55 campaign
    56 care
    57 clubs
    58 containment project
    59 countries
    60 data
    61 data triangulation
    62 demographics
    63 depth interviews
    64 development
    65 discussion
    66 effectiveness
    67 effectiveness of interventions
    68 elimination
    69 evaluation
    70 exposure
    71 factors
    72 focus group discussions
    73 future interventions
    74 gap
    75 general population
    76 group
    77 group discussions
    78 health care
    79 healthcare
    80 high mobility
    81 impact
    82 implementation oversights
    83 inadequate exposure
    84 intervention
    85 interviews
    86 key factors
    87 lack
    88 lessons
    89 little impact
    90 low access
    91 low access thwarts interventions
    92 low-impact activities
    93 malaria containment project
    94 malaria elimination
    95 malaria workers
    96 mass media campaigns
    97 maximum potential
    98 media campaigns
    99 migrant populations
    100 mixed-method study
    101 mobility
    102 order
    103 oversight
    104 paper
    105 part
    106 planning
    107 population
    108 potential
    109 process
    110 project
    111 qualitative data
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    113 questionnaire
    114 reach
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    116 risk demographics
    117 risky behaviors
    118 seasonal workers
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