The Karen people, often living in isolated areas with limited access to healthcare, have traditionally seen malaria control as a responsibility solely of government agencies, not their own. However, thanks to the Community-Led Monitoring (CLM) approach, supported by the Global Fund’s RAI4E programme and implemented by the Raks Thai Foundation (RTF), the community has begun to take charge of its health, transforming how it addresses malaria.
The biggest challenge the Karen community faced in adopting CLM was changing their mindset. Malaria control was seen as an external responsibility for years, and many villagers were unaware of their potential role in preventing it. Educational efforts led by the Raks Thai Foundation helped local leaders, religious figures, and village health volunteers (VHVs) understand the malaria situation and the role they could play in controlling it.
The CLM Approach in Action: Engaging the Community
The process of implementing CLM in Pa Deng started with a series of collaborative steps. Community leaders and RTF staff held planning meetings to discuss malaria and identify priorities. Together, they identified their interests and developed data collection tools, including questionnaires designed to gather information from 70% of households in the village. Community representatives and VHVs were trained to collect the data and necessary information, with guidance provided by project staff on data analysis.
This data collection process revealed several key needs and concerns within the community, including the desire for faster response times during malaria outbreaks. Villagers requested that a chemical spraying device be readily available in the village so that they could use it immediately during an outbreak without waiting for government intervention.
“We want local residents to be trained and responsible for spraying chemicals, as locals understand the area and can explain the need for spraying to households better than those who are from outside,” the locals said. “We would like to be notified two days in advance before spraying so we can prepare our homes,” was a common suggestion. These insights were shared in village meetings and then presented to the subdistrict-level malaria working group.
The Pa Deng community’s malaria elimination efforts took a major step forward. A malaria elimination team was formed and trained in long-lasting indoor residual spraying techniques, empowering locals to respond swiftly to outbreaks. Malaria education was integrated into religious gatherings, with church leaders using Sunday services to raise awareness.
Religious leaders also helped raise funds to purchase a chemical spray tank for the village, ensuring they could act promptly when needed. A subdistrict-level malaria working group was established, and malaria prevention was included in the 2025 subdistrict budget. Today, community leaders regularly share malaria prevention messages through loudspeakers, ensuring everyone stays informed and engaged.
Broader Impact in other Communities and Provinces
While Pa Deng's success is a powerful example of CLM’s impact, it is just one part of a larger effort taking place across Thailand’s border provinces. The CLM approach is being implemented in other malaria-endemic areas, where communities are similarly empowered to take charge of their health.
In provinces like Mae Hong Son and Tak, local communities are also participating in malaria prevention and control activities, with the same emphasis on local ownership and participation. These communities are working to gather information, identify needs, and implement solutions relevant to their unique contexts to combat malaria and improve health outcomes.
By equipping communities with the knowledge and tools to manage their health, CLM offers a sustainable model for long-term improvements in both health and overall well-being. As the initiative grows, the vision of healthier, more resilient communities is becoming a reality. Whether in border areas or more stable regions, empowered local communities are leading the way in improving their own health outcomes.
