Abstract
BackgroundThe current stage of malaria elimination in China requires experienced local health workers with sufficient knowledge of malaria who help to keep the public health system vigilant about a possible resurgence. However, the influencing factors of local health workers’ knowledge level are not fully comprehended. This study aims to explore the factors with heavy impact on local health worker’s knowledge of malaria and propose corresponding suggestions.MethodsUnderpinned by stratified sampling method, a cross-sectional survey was carried out between November 2014 and April 2016. Chi square test was performed to identify the factors with potential influence on health workers’ knowledge level of malaria. Bivariate logistic regression was employed to explore the relationship between the predictors and local health workers’ knowledge level of malaria. Layered Chi square test was used to calculate the homogeneity of the interaction between training approaches and the percentage of participants with high-level knowledge.ResultsThe endemic type of county and type of organization played the most significant role in influencing local health workers’ knowledge level regarding malaria in the sample population. The participants from Type 1 and Type 2 counties were 4.3 times (4.336 and 4.328, respectively) more likely to have high-level knowledge of malaria than those who work in Type 3 counties. The probability of having high-level knowledge amongst the participants from county-level facilities (county hospitals and CDCs) were more than 2.2 times higher than those who work in villages. Other socio-demographic factors, such as education and work experience, also affected one’s knowledge regarding malaria. Amongst the six most-used training approaches, electronic material (OR = 2.356, 95% CI 1.112–4.989), thematic series (OR = 1.784, 95% CI 0.907–3.508) and supervision (OR = 2.788, 95% CI 1.018–7.632) were proven with significant positive impact on local health workers’ knowledge of malaria.ConclusionVillage doctors and who served in Type 3 counties were identified as the ones in urgent need of effective training. Three types of training approaches, including electronic material, thematic series and supervision, were proven to be effective in improving local health workers’ knowledge. Nevertheless, the coverage of these training approaches was still limited. This study suggests expanding the coverage of training, especially the three particular types of training, to local health workers, particularly to the target populations (village doctors and who served in Type 3 counties). Online training, small group discussion and targeted skill development may be the directions for the future development of training programmes.
Highlights
The current stage of malaria elimination in China requires experienced local health workers with sufficient knowledge of malaria who help to keep the public health system vigilant about a possible resurgence
Participants who had received electronic material, thematic series or skill development training respectively accounted for 51.1%, 54.2% and 43.6% of the sample population
The study results illustrate that the knowledge level of malaria is closely related to the background of participants, including the endemic type of county, type or organization, education and work experience, whereas it is influenced by the use of appropriate training approaches, including electronic material, thematic series and supervision
Summary
The current stage of malaria elimination in China requires experienced local health workers with sufficient knowledge of malaria who help to keep the public health system vigilant about a possible resurgence. This study aims to explore the factors with heavy impact on local health worker’s knowledge of malaria and propose corresponding suggestions. Since the establishment of the National Malaria Control Programme, the Chinese government has made huge efforts into control the spread of the disease [4]. Since the Chinese government successfully built a close collaborative relationship with the Global Fund in 2004, the past 10 years has witnessed an effective control of the malaria endemic [5]. The economic globalization has led to a dramatic increase in the number of Chinese migrant workers in sub-Saharan Africa, which contributed to a rapid increase of imported cases [2, 7]. It has become a consensus that the imported cases and the left hard-toreach indigenous cases are the major challenges in the current elimination phase, and this calls for new strategies for new challenges [8, 9]
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