Abstract
BackgroundMicroscopists have active roles in bringing malaria diagnosis and treatment closer to households in Palawan, the highest malaria-endemic province in the Philippines. To accelerate the elimination of malaria in Palawan, we performed a study based on the bottom-up approach to provide profound data to strengthen this community-based malaria control from the microscopists’ point of view.MethodsWe performed a qualitative cross-sectional study in Palawan. Four focus group discussions with 50 microscopists were conducted in Palawan from November 2010 to February 2011. During the discussions, the following open-ended questions were addressed: motivation for applying to be microscopists in the “Past” category; job satisfaction, role, problems, and saddest and happiest experiences working as microscopists in the “Present” category; and willingness towards task shifting in the “Future” category. Data were transcribed and analyzed by framework analysis using the NVivo software program.ResultsThe present study innovatively proposed the following strategies: reinforcement strategy (adequate supplies and settings), highly prioritized additional strategies (improving social status of microscopists, issuing a travel budget, and including indigenous populations), regional additional strategies (additional malaria control in the southern region and task shifting in the northern region), and less prioritized additional strategies (employment policy and health checkup).ConclusionA bottom-up approach using microscopists’ perceptions would be a valuable method to propose practical and effective additional strategies for strengthening community-based malaria control.
Highlights
Microscopists have active roles in bringing malaria diagnosis and treatment closer to households in Palawan, the highest malaria-endemic province in the Philippines
The present study explained the methods of extracting findings from qualitative data on the community health workers (CHWs)’ perceptions that were relevant to intervention design. We gleaned such spatiotemporal and multilateral perceptions of the CHWs as motivation for applying to be microscopists in the “Past” category; job satisfaction, role, problems, and saddest and happiest experiences working as microscopists in the “Present” category; and willingness towards task shifting in the “Future” category, and tried to provide a path to promote a better strategy in an articulate manner
Focus group discussions (FGDs) employing a total number of 50 microscopists were successfully conducted in two municipalities (Taytay and San Vicente) from the northern region in February 2011 and in two municipalities (Bataraza and Brooke’s Point) from the southern region in November 2010 (Table 2)
Summary
Microscopists have active roles in bringing malaria diagnosis and treatment closer to households in Palawan, the highest malaria-endemic province in the Philippines. Palawan has the highest incidence/prevalence of malaria among the endemic provinces of the Philippines, where microscopists, as community health workers (CHWs), have active roles in bringing malaria diagnosis and treatment closer to households to support the limited health care services [1, 2]. Microscopists in Palawan prepare Giemsa-stained blood smears, identify malaria infection and species, give anti-malaria drugs if necessary, and conduct community awareness-raising activities for malaria prevention [2]. This community-based malaria control, Kilusan Ligtas Malaria (KLM, Tagalog: Movement Against Malaria), was launched in 1999, and since early diagnosis and prompt treatment have been implemented and scaled-up throughout Palawan. Additional strategies to further strengthen the KLM are earnestly desired in Palawan
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