CONTAINMENT

contain + eliminate = no parasite

Using Taxi Drivers and Radio to Reach Mobile Migrant Workers

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Dr. Kheang Soy Ty, Chief of Party of the USAID-funded Cambodia Malaria Prevention and Control Project (MCC) and Khorn Linna, a communications specialist with Partners for Development (PFD) tell CONTAINMENT of their efforts to raise malaria awareness among mobile migrant workers. The MCC, in partnership with Partners for Development, works in Cambodia’s western provinces where malaria is a serious public health problem.

MCC's Dr. Kheang Soy Ty (left) and PFD's Khorn Linna. Pix by WHO/Sonny Krishnan

 

Why has the project chosen taxi-drivers to spread knowledge among migrant workers about the cause of malaria?

Dr. Soy Ty: Before we chose this strategy, we did focus group discussions (FGDs) with village chiefs and staff in health centers. The FGDs also included those from the mobile and migrant population. The FGD results indicated that the majority of migrant workers, from other provinces, used taxis to get to Western Cambodia. For many of these migrant workers, especially from the southeastern part of Cambodia that borders Vietnam, the taxi drivers are their first point of contact in the West. Also from the FGDs we found out that the popular taxi routes are from Battambang to Samlaut; Battambang to Sampov Luo; and Battambang to Pailin.

The southeast part of Cambodia has no falciparum malaria cases. So you have people moving from areas of low endemicity to areas of high endemicity. The migrant workers make their way to the West, especially during the harvest season, to work in the plantations.

How are the taxi-drivers trained to raise awareness of malaria among migrant workers?

Khorn Linna: First we conducted an FGD with three groups of taxi drivers that carried migrant workers along the following routes: Battambang to Samlaut; Battambang to Sampov Luo; Battambang to Pailin.  We wanted to find out whether we could collaborate with these drivers and we also wanted to assess their basic knowledge on malaria prevention. Besides that, the FGDs also gave us a good opportunity to find out from the taxi drivers what were the best kinds of IEC [Information, Education and Communication] materials that they [taxi drivers] could give out to their migrant worker passengers.

After the FGDs, we started the first training of taxi drivers in Battambang. We had 33 drivers from the three different locations in the training. The training was to ensure that the taxi drivers disseminated accurate information on malaria prevention and treatment to their migrant worker passengers. Because they were the primary message providers, as the first point of contact for migrant workers, we also had to make sure these taxi drivers had good communication skills.

Now we have 33 taxi drivers in our network and we plan to conduct quarterly workshops to monitor and evaluate their activities, and also evaluate the IEC materials that we have developed jointly with the drivers.

Are the taxi-drivers also trying to change the treatment-seeking behaviour of migrant workers – like seeking out the village malaria worker first for diagnosis and treatment if they have fever, rather than going to the pharmacy for self-medication?

Dr. Soy Ty: In the training programmes, we ensure that the taxi drivers themselves have accurate information on malaria transmission and also adequate knowledge of the vector in its ability to transmit malaria. Also through the training programmes, the drivers know the symptoms of malaria or suspected malaria – the fevers, chills, headaches, cold sweats etc. The taxi-drivers are also made aware of the location of health facilities and village malaria workers along the Pailin, Samlaut and Sampov Luo routes, where migrant workers can get free diagnosis and treatment for malaria. All these packets of information are important because the taxi drivers will be able to advise the migrant workers on what to do if they have fever and where to seek free diagnosis and treatment, rather than going to the drug outlets or pharmacies first.

We are also thinking one step further in working with the private sector – especially with the drug outlets and pharmacies. These places are popular with Khmers, so why not they be also used to sell high-subsidised bed-nets?

Are the taxi drivers also distributing bed-nets to migrant workers?

Dr. Soy Ty: Not at this stage of the project. We recognize the role of taxi drivers in distributing bed-nets. But the question is: from where should we get the bed nets? This is a question of sustainability and we need to coordinate with the National Malaria Programme. Recently MCC and its other partners discussed bed-net distribution using a voucher system, where taxi drivers could give out vouchers to their migrant worker passengers. The migrant workers then can redeem them for bed-nets at the public health facilities in the areas where they are going to find work. We hope to be able to get bed-nets from the National Malaria Program for this pilot programme.

We are also thinking one step further in working with the private sector – especially with the drug outlets and pharmacies. These places are popular with Khmers, so why not also use them to sell high-subsidised bed-nets?

In your behaviour change communication efforts, how do you encourage migrant workers to use bed-nets?

Khorn Linna: Most of the migrant workers are from provinces where virtually there is no malaria. So the majority of them really don’t know about the vector-borne disease. It’s not a matter of just making available Information, Education and Communication (IEC) materials but also determining which is the best way to reach them in terms of increasing their knowledge on malaria.

We found, through FGDs, that radio as a channel of communication was the best means to reach out to these migrant workers. Based on the findings of the FGDs, we have started working with [a media development INGO] Equal Access to produce interactive radio call-in shows. These radio programs are really popular with migrant workers because it enables them to interact with the presenters, with calls made to the radio station on their mobile phones. MCC, PFD and Equal Access are also involved in training the radio presenters to give out accurate technical information on malaria prevention.

Dr. Soy Ty: We also have what we call a Malaria Week, which is an intense activity in the very remote villages in containment zones 1 and 2. In zone 1 we cover Battambang and Pailin and zone 2 it’s Banteay Meanchey and Otdar Meanchey.

In Malaria Week we have teams moving from one village to the next with loudspeakers disseminating information on how malaria is transmitted. Our objective is very clear. We are mobilizing the community, including mobile migrant workers, to sleep under bed-nets. Malaria Week happens every April, just before the onslaught of the rainy season.

An image from URC's flip-chart, promoting the use of hammock nets among migrant workers who work and sleep in the fields.

URC has also developed a flip chart for migrant workers with strong images and little or no words. They seem to be effective as an IEC material on malaria prevention. Why is it so?

This flip chart was developed by working very closely with communities [where malaria is rife] and their views solicited on what images they wanted to see in IECs. We used very few words in the flip chart because they would not make sense to Cambodians who are illiterate and concentrated instead on making the pictures understood visually at one glance. We field-tested the flip chart before releasing it. So far we have received very positive feedback. It seems to be working in getting the preventive messages across.

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Written by malariacontainment

November 2, 2010 at 5:08 pm

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