Village malaria workers play a pivotal role in preventing and treating malaria in areas located far away from the public healthcare coverage in Cambodia. Their tasks range from preventive activities such as organising awareness-raising sessions in the community, to testing and diagnosing malaria and providing treatment for those who have fallen ill. The village malaria workers are also involved in distribution of long-lasting insecticide treated nets, also known as LLINs, in the malaria endemic communities. Mobile malaria workers carry out similar tasks, but target at-risk mobile and migrant populations, such as people working in Cambodia’s forests and plantations.
The remoteness of the areas where village malaria workers operate means that they are not only far away from the public healthcare coverage – they are often cut off from basic financial services, too. Few rural Cambodians have a bank account in their name and payments to the village malaria workers were up until 2015 made in cash, a system with inherent risks and weaknesses. In 2017, RAI2E piloted a system where village malaria workers receive their travel and incentive allowances via e-payments, either directly to their phones or in the form of a unique code that can be presented at a local agent to collect cash. The results of the pilot were uplifting. RAI2E is now using two different e-payment providers that in total can provide services in 70 percent of the country. In 2017, 3,247 village malaria workers that had previously worked for RAI were identified, registered with one of the e-payment providers and re-trained. In the second half of 2017, these village malaria workers tested 39,000 people for malaria and provided malaria treatment for 8,761 people in 2,071 villages. An additional 1,493 village malaria workers will take up their duties across Cambodia in the first months of 2018 after being registered and re-trained.
Introducing e-payments was only one of several improvements that were implemented in 2017 to ensure the quality and efficiency of the RAI2E programme implementation in Cambodia. In total, more than 7,000 care providers were trained on new guidelines for malaria diagnosis and treatment, malaria surveillance and apps for real time reporting to allow timely case notification, foci investigation and management. A new programme management framework is in place and RAI2E partners from e.g. the National Centre for Parasitology, Entomology and Malaria Control, the Provincial Health Department, the District Health Departments and NGOs have been trained in the new framework and RAI2E’s standard operational procedures.
In the wake of the recent increase in reported malaria cases, higher-risk areas is being targeted for distribution of LLINs to protect against mosquito bites. Half a million LLINs have been distributed during the course of a few months and the distribution will continue until all communities have been reached. In addition, RAI2E plans to replace the 2.5 million LLINs that were distributed in 2014 through health centres and village malaria workers. These bed nets have now reached the end of their longevity, and RAI2E aims to replace them before the rainy season, when transmission normally peaks.
