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

Abstract Background Malaria is one of the major public health problems in Myanmar. Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS). This countrywide analysis aimed to assess and compare the acces...

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Main Authors: Nay Yi Yi Linn, Soundappan Kathirvel, Mrinalini Das, Badri Thapa, Md. Mushfiqur Rahman, Thae Maung Maung, Aye Mon Mon Kyaw, Aung Thi, Zaw Lin
Format: Article
Language:English
Published: BMC 2018-06-01
Series:Malaria Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12936-018-2384-4
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author Nay Yi Yi Linn
Soundappan Kathirvel
Mrinalini Das
Badri Thapa
Md. Mushfiqur Rahman
Thae Maung Maung
Aye Mon Mon Kyaw
Aung Thi
Zaw Lin
author_facet Nay Yi Yi Linn
Soundappan Kathirvel
Mrinalini Das
Badri Thapa
Md. Mushfiqur Rahman
Thae Maung Maung
Aye Mon Mon Kyaw
Aung Thi
Zaw Lin
author_sort Nay Yi Yi Linn
collection DOAJ
description Abstract Background Malaria is one of the major public health problems in Myanmar. Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS). This countrywide analysis aimed to assess and compare the accessibility to- and quality of malaria care (treatment initiation, treatment within 24 h and complete treatment delivery) between VHV and BHS in Myanmar. Methods This was a retrospective cohort study using record review of routinely collected programme data available in electronic format. All patients with undifferentiated fever screened and diagnosed for malaria in January–December 2015 by VHV and BHS under National Malaria Control Programme in Myanmar were included in the study. 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, 11.0% of patients were found malaria positive and the malaria positivity in VHV and BHS group were 11.1 and 10.9% respectively. Access to malaria care: higher proportion of children aged 5–14 years (21.8% vs 17.3%) and females (43.7% vs 41.8%) with fever were screened for malaria by VHV compared to BHS. However, the same for children aged < 5 years was 2.2% lower in VHV group compared to BHS. Quality of malaria care: the proportion of malaria cases that received treatment was 96.6 and 94.9; treatment initiation within 24 h of fever was 44.7 and 34.1; and, complete treatment delivery was 80.9 and 88.2, respectively, in VHV and BHS groups. After adjustment for potential confounders, patients with malaria provided care by VHV had 1.02 times higher chance of receiving treatment compared to BHS [aPR (95% confidence interval) 1.017 (1.015, 1.020)]. Conclusions The VHV were more accessible to children and women than BHS in providing malaria screening services. The malaria treatment services provided by VHV was as good as BHS. Further qualitative research to explore and address the challenges on initiation and delivering complete treatment by VHV including inventory assessment and cost-effectiveness studies on integration of VHV in routine health system are needed.
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spelling doaj.art-9fed63a3c1024e44a5c7490f13839bbd2022-12-21T23:54:15ZengBMCMalaria Journal1475-28752018-06-0117111210.1186/s12936-018-2384-4Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015Nay Yi Yi Linn0Soundappan Kathirvel1Mrinalini Das2Badri Thapa3Md. Mushfiqur Rahman4Thae Maung Maung5Aye Mon Mon Kyaw6Aung Thi7Zaw Lin8National Malaria Control Programme, Department of Public Health, Ministry of Health and SportsThe International Union of Tuberculosis and Lung Diseases, Union South-East Asia Regional OfficeMédecins Sans Frontières-OCBWorld Health Organization Country Office for MyanmarWorld Health Organization Country Office for MyanmarDepartment of Medical Research, Ministry of Health and SportsNational Malaria Control Programme, Department of Public Health, Ministry of Health and SportsNational Malaria Control Programme, Department of Public Health, Ministry of Health and SportsNational Malaria Control Programme, Department of Public Health, Ministry of Health and SportsAbstract Background Malaria is one of the major public health problems in Myanmar. Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS). This countrywide analysis aimed to assess and compare the accessibility to- and quality of malaria care (treatment initiation, treatment within 24 h and complete treatment delivery) between VHV and BHS in Myanmar. Methods This was a retrospective cohort study using record review of routinely collected programme data available in electronic format. All patients with undifferentiated fever screened and diagnosed for malaria in January–December 2015 by VHV and BHS under National Malaria Control Programme in Myanmar were included in the study. 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, 11.0% of patients were found malaria positive and the malaria positivity in VHV and BHS group were 11.1 and 10.9% respectively. Access to malaria care: higher proportion of children aged 5–14 years (21.8% vs 17.3%) and females (43.7% vs 41.8%) with fever were screened for malaria by VHV compared to BHS. However, the same for children aged < 5 years was 2.2% lower in VHV group compared to BHS. Quality of malaria care: the proportion of malaria cases that received treatment was 96.6 and 94.9; treatment initiation within 24 h of fever was 44.7 and 34.1; and, complete treatment delivery was 80.9 and 88.2, respectively, in VHV and BHS groups. After adjustment for potential confounders, patients with malaria provided care by VHV had 1.02 times higher chance of receiving treatment compared to BHS [aPR (95% confidence interval) 1.017 (1.015, 1.020)]. Conclusions The VHV were more accessible to children and women than BHS in providing malaria screening services. The malaria treatment services provided by VHV was as good as BHS. Further qualitative research to explore and address the challenges on initiation and delivering complete treatment by VHV including inventory assessment and cost-effectiveness studies on integration of VHV in routine health system are needed.http://link.springer.com/article/10.1186/s12936-018-2384-4Health workforceAccessibilityQuality of careCommunity health workerPerformanceGreater Mekong Sub-region
spellingShingle Nay Yi Yi Linn
Soundappan Kathirvel
Mrinalini Das
Badri Thapa
Md. Mushfiqur Rahman
Thae Maung Maung
Aye Mon Mon Kyaw
Aung Thi
Zaw Lin
Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
Malaria Journal
Health workforce
Accessibility
Quality of care
Community health worker
Performance
Greater Mekong Sub-region
title Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
title_full Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
title_fullStr Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
title_full_unstemmed Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
title_short Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
title_sort are village health volunteers as good as basic health staffs in providing malaria care a country wide analysis from myanmar 2015
topic Health workforce
Accessibility
Quality of care
Community health worker
Performance
Greater Mekong Sub-region
url http://link.springer.com/article/10.1186/s12936-018-2384-4
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