249921 Expansion of a malaria control program in Eastern Burma's active-conflict area and the need for a community-based approach

Monday, October 31, 2011: 3:42 PM

Karen Chang, MHS , Global Health Access Program, Berkeley, CA
Eh Kalu Shwe Oo , Karen Department of Health and Welfare, Berkeley, CA
Linda Smith, MHS , Global Health Access Program, Berkeley, CA
Adam K. Richards, MD, MPH , Global Health Access Program, Berkeley, CA
Thomas J. Lee, MD, MHS , Global Health Access Program, Berkeley, CA
Jennifer Leigh, MPH , Field Director, Global Health Access Program, San Francisco, CA
Sakloe Chaya , Malaria Control Program Coordinator, Karen Department of Health and Welfare, Mae Sot, Thailand
The malaria control program of the Karen Department of Health and Welfare (KDHW) has striven to provide universal coverage in areas of active conflict in Eastern Burma. KDHW piloted a community-based malaria control program in 2003, shifting resources from the clinic to the community by actively seeking, testing and treating febrile patients with WHO recommended technologies, such as quality rapid diagnostics and Artesunate combination therapy. As the program scaled up and intensive active management and outreach grew taxing on small clinic-based teams, utility of traditional birth attendants for outreach allowed the program to reach vulnerable populations, including pregnant women and children. Eventually, training of lay community members established a more comprehensive community-based approach with expansion to remote areas and those more vulnerable to security threats. Consistent with WHO recommendations to combat emerging Artesunate resistance in South-East Asia and empowering communities to continue providing care when security risks might isolate villages from clinic-based services, lay community members conduct routine house visits to teach prevention and monitor use of long-lasting insecticide treated nets, promptly identify new cases, and treat using a simplified protocol. Health workers' roles have evolved to assume supervisory roles in training and monitoring lay community members. Following the example of Cambodia's national program utilizing Village Malaria Workers, KDHW's program has been able to expand its coverage from a population of 3,000 to over 50,000 and improve its health worker to community population ratio from 1:455 to 1:187 in just eight years.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Program planning
Provision of health care to the public

Learning Objectives:
Demonstrate the capacity of a community based organization to implement a malaria control program in an area of active conflict in Eastern Burma Describe its use of lay community members in expanding its malaria control program and striving towards universal coverage

Keywords: Community Health Programs, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the coordinator in charge of the Malaria Control program with KDHW and the presentation is about that work.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.