Abstract
BackgroundAlthough Guyana has made significant progress toward malaria control, limited access to malaria testing and treatment services threatens those gains. Mining activities create breeding environments for mosquitoes, and the migrant and mobile mining populations are hard to reach with information and services. The Ministry of Public Health (MoPH) has trained volunteers to test and treat malaria cases in remote regions. However, it remains unclear how miners perceive these testers, the services they provide, or what their malaria care-seeking behaviour is in general. To better address these challenges, Breakthrough ACTION Guyana and MoPH conducted qualitative research from October to November 2018 in Regions 7 and 8 in Guyana.MethodsA total of 109 individuals, 70 miners, 17 other mining camp staff, and 22 other key stakeholders (e.g. community health workers, pharmacists, and regional leadership), participated in semi-structured interviews and focus group discussions. Results were derived using a framework analysis, with an adjusted doer and non-doer analysis, and organized using the integrated behaviour framework.ResultsMiners sought MoPH-approved services because of close geographic proximity to testing services, a preference for public service treatment, and a desire to correctly diagnose and cure malaria rather than just treat its symptoms. Those who chose to initiate self-treatment—using unregulated medications from the private and informal sector—did so out of convenience and the belief that self-treatment had worked before. Miners who completed the full MoPH-approved treatment understood the need to complete the treatment, while those who prematurely stopped treatment did so because of medication side effects and a desire to feel better as soon as possible.ConclusionReasons why miners do and do not pursue malaria testing and treatment services are diverse. These results can inform better MoPH programming and new solutions to improve malaria outcomes in Guyana.
Highlights
Guyana has made significant progress toward malaria control, limited access to malaria testing and treatment services threatens those gains
This study aims to understand behavioural barriers and opportunities to improve testing and treatment for malaria as part of the first stage of the larger Breakthrough ACTION Guyana initiative, a social and behaviour change (SBC) project led by Johns Hopkins Center for Communication Programs (CCP)
10 Rapid diagnostic test (RDT) testers, seven pharmacists and community health workers (CHWs), and nine other individuals participated
Summary
Guyana has made significant progress toward malaria control, limited access to malaria testing and treatment services threatens those gains. The Ministry of Public Health (MoPH) has trained volunteers to test and treat malaria cases in remote regions. It remains unclear how miners perceive these testers, the services they provide, or what their malaria care-seeking behaviour is in general. To better address these challenges, Breakthrough ACTION Guyana and MoPH conducted qualitative research from October to November 2018 in Regions 7 and 8 in Guyana. Malaria disproportionately affects men (70% of all cases), Amerindians (43% of all cases), and people aged 15 to 49 (73.2% of all cases) (Trotman 2018, pers. commun.)
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