Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo
1
Issued Date
2023-12-01
Resource Type
eISSN
14752875
Scopus ID
2-s2.0-85176118518
Journal Title
Malaria Journal
Volume
22
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Malaria Journal Vol.22 No.1 (2023)
Suggested Citation
Naserrudin N.A., Lin P.Y.P., Monroe A., Baumann S.E., Adhikari B., Miller A.C., Sato S., Fornace K.M., Culleton R., Cheah P.Y., Hod R., Jeffree M.S., Ahmed K., Hassan M.R. Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo. Malaria Journal Vol.22 No.1 (2023). doi:10.1186/s12936-023-04750-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/91067
Title
Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
London School of Hygiene & Tropical Medicine
Nord Universitet
Universiti Malaysia Sabah
National University of Singapore
Kementerian Kesihatan Malaysia
Nuffield Department of Medicine
Johns Hopkins University
University of Pittsburgh Graduate School of Public Health
University of Oxford Medical Sciences Division
Ehime University
University of Glasgow
Faculty of Medicine, UKM
London School of Hygiene & Tropical Medicine
Nord Universitet
Universiti Malaysia Sabah
National University of Singapore
Kementerian Kesihatan Malaysia
Nuffield Department of Medicine
Johns Hopkins University
University of Pittsburgh Graduate School of Public Health
University of Oxford Medical Sciences Division
Ehime University
University of Glasgow
Faculty of Medicine, UKM
Other Contributor(s)
Abstract
Background: The increasing incidence of Plasmodium knowlesi malaria poses a significant challenge to efforts to eliminate malaria from Malaysia. Macaque reservoirs, outdoors-biting mosquitoes, human activities, and agricultural work are key factors associated with the transmission of this zoonotic pathogen. However, gaps in knowledge regarding reasons that drive malaria persistence in rural Kudat, Sabah, Northern Borneo remain. This study was conducted to address this knowledge gap, to better understand the complexities of these entangled problems, and to initiate discussion regarding new countermeasures to address them. This study aims to highlight rural community members’ perspectives regarding inequities to health relating to P. knowlesi malaria exposure. Methods: From January to October 2022, a study using qualitative methods was conducted in four rural villages in Kudat district of Sabah, Malaysia. A total of nine in-depth interviews were conducted with community and faith leaders, after the completion of twelve focus group discussions with 26 photovoice participants. The interviews were conducted using the Sabah Malay dialect, audio-recorded, transcribed, and translated into English. The research team led the discussion and analysis, which was approved by participants through member checking at the community level. Results: Participants identified disparity in health as a key issue affecting their health and livelihoods. Injustice in the social environment was also identified as a significant challenge, including the importance of listening to the voices of affected communities in disentangling the social and economic phenomena that can impact malaria control. Specific concerns included inadequate access to health-related resources and degradation of the environment. Participants recommended improving access to water and other necessities, increasing the availability of malaria control commodities in healthcare facilities, and developing sustainable programs to reduce socioeconomic disparities. Conclusion: Inequities to health emerged as a key concern for malaria control in rural Kudat, Sabah. A locally targeted malaria programme cantered on improving the social and economic disparities associated with health outcomes, could be a potential strategy for malaria prevention in such areas. Community-level perspectives gathered from this study can be used as a foundation for future discussions and dialogues among policymakers and community members for achieving greater transparency, improving social equity, and interoperability in addressing P. knowlesi malaria control.