Internally displaced human resources for health: Villager health worker partnerships to scale up a malaria control programme in active conflict areas of eastern Burma

• Published in: Global public health Vol. 4; no. 3; pp. 229 - 241
• Main Authors: Lee, C.I., Smith, L.S., Shwe Oo, E.K., Scharschmidt, B.C., Whichard, E., Kler, Thart, Lee, T.J., Richards, A.K.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 01.05.2009
• Subjects: Access to health care; Burma; Community Health Workers - education; Community Health Workers - organization & administration; Community Networks - organization & administration; Conflict; Displaced persons; Health professionals; Health Services Accessibility - organization & administration; human resources for health; Human rights; Humans; internally displaced persons; Malaria; Malaria - epidemiology; Malaria - prevention & control; malaria control; Medical personnel; Myanmar - epidemiology; Pilot Projects; Refugees - education; Refugees - psychology; Resources; Rural communities; village health workers; Villages; Warfare; Myanmar
• ISSN: 1744-1692; 1744-1706
• DOI: 10.1080/17441690802676360

Approaches to expand malaria control interventions in areas of active conflict are urgently needed. Despite international agreement regarding the imperative to control malaria in eastern Burma, there are currently no large-scale international malaria programmes operating in areas of active conflict. A local ethnic health department demonstrated that village health workers are capable of implementing malaria control interventions among internally displaced persons (IDPs). This paper describes how these internally displaced villagers facilitated rapid expansion of the programme. Clinic health workers received training in malaria diagnosis and treatment, vector control and education at training sites along the border. After returning to programme areas inside Burma, they trained villagers to perform an increasingly comprehensive set of interventions. This iterative training strategy to increase human resources for health permitted the programme to expand from 3000 IDPs in 2003 to nearly 40,000 in 2008. It was concluded that IDPs are capable of delivering essential malaria control interventions in areas of active conflict in eastern Burma. In addition, health workers in this area have the capacity to train community members to take on implementation of such interventions. This iterative strategy may provide a model to improve access to care in this population and in other conflict settings.