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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/42851
Title: Community engagement and the social context of targeted malaria treatment: a qualitative study in Kayin (Karen) State, Myanmar
Authors: Kate Sahan
Christopher Pell
Frank Smithuis
Aung Kyaw Phyo
Sai Maung Maung
Chanida Indrasuta
Arjen M. Dondorp
Nicholas J. White
Nicholas P.J. Day
Lorenz Von Seidlein
Phaik Yeong Cheah
University of Oxford
University of Amsterdam
Medical Action Myanmar
Nuffield Department of Clinical Medicine
Mahidol University
Amsterdam Institute for Global Health and Development
Keywords: Immunology and Microbiology
Issue Date: 14-Feb-2017
Citation: Malaria Journal. Vol.16, No.1 (2017)
Abstract: © 2017 The Author(s). Background: The spread of artemisinin-resistance in Plasmodium falciparum is a threat to current global malaria control initiatives. Targeted malaria treatment (TMT), which combines mass anti-malarial administration with conventional malaria prevention and control measures, has been proposed as a strategy to tackle this problem. The effectiveness of TMT depends on high levels of population coverage and is influenced by accompanying community engagement activities and the local social context. The article explores how these factors influenced attitudes and behaviours towards TMT in Kayin (Karen) State, Myanmar. Methods: Semi-structured interviews were conducted with villagers from study villages (N = 31) and TMT project staff (N = 14) between March and July 2015. Results: Community engagement consisted of a range of activities to communicate the local malaria situation (including anti-malarial drug resistance and asymptomatic malaria), the aims of the TMT project, and its potential benefits. Community engagement was seen by staff as integral to the TMT project as a whole and not a sub-set of activities. Attitudes towards TMT (including towards community engagement) showed that developing trusting relationships helped foster participation. After initial wariness, staff received hospitality and acceptance among villagers. Offering healthcare alongside TMT proved mutually beneficial for the study and villagers. A handful of more socially-mobile and wealthy community members were reluctant to participate. The challenges of community engagement included time constraints and the isolation of the community with its limited infrastructure and a history of conflict. Conclusions: Community engagement had to be responsive to the local community even though staff faced time constraints. Understanding the social context of engagement helped TMT to foster respectful and trusting relationships. The complex relationship between the local context and community engagement complicated evaluation of the community strategy. Nonetheless, the project did record high levels of population coverage.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85012865049&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/42851
ISSN: 14752875
Appears in Collections:Scopus 2016-2017

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