Under the Global Fund’s RAI3E Grant, the VietMCI consortium – led by Supporting Community Development Initiatives (SCDI), Health Poverty Action, and the Vietnam Public Health Association – is working to ensure malaria services reach the very last mile.

Trained community health workers affiliated with retail pharmacies and drug shops, private clinics, and civil society organizations are essential to national malaria programme efforts to bring malaria prevention, testing, and treatment information and services as close to forest-exposed communities as possible. Targeted community engagement is critical to finding and treating every last malaria case.

During the first three quarters of 2022, 34% of the malaria cases reported in Viet Nam were identified through the private sector and community channels. In comparison, 15% of Viet Nam's largest funding source for malaria elimination is allocated to civil society and private sector outreach.

Community engagement is critical to ending malaria – even in Viet Nam where the public health system provides many aspects of malaria and other primary care services to the commune level.

Communities living or working in the forest face several barriers limiting their healthcare access. By bringing primary malaria prevention and testing services out of health facilities and closer to communities, civil society organizations and trained private community health workers can help national malaria programmes improve convenient access to and uptake of vector control products and rapid point-of-care screening tools that can both prevent and identify malaria transmission more swiftly. The community outreach workers contribute to malaria case finding, prevention, and bringing malaria cases to health facilities.

Mixed health system solutions, including contributions from private, civil society, and public service delivery channels, are critical to meet the needs of communities at risk and to test, treat and report every last case of malaria.

Ms. Pho La, a rubber farmer in Loc Ninh district of Binh Phuoc province on the Viet Nam–Cambodia border, is one of the community outreach workers trained and supported by civil society partners. The critical role of community outreach workers is to counsel and refer patients with malaria symptoms to public health facilities. They can leverage their deep understanding of local barriers to prompt, complete care for malaria symptoms among remote and mobile community members with limited access to public health facilities.

Mr. Lam, a member of the local Kho Me ethnic minority, who makes a living as a farmer planting orchid flowers and rubber in Binh Phuoc province, shared his experience on the difference community outreach has made in his life.

Before the COVID-19 pandemic, Lam regularly crossed the border and experienced malaria several times. Recently when he had a fever, he did not think he could have malaria again. “My neighborhood community outreach worker Ms. Pho La convinced me to visit a health facility for a test, as I had malaria symptoms. I was initially reluctant to go because I did not think I would have malaria again. But, when I went to the health facility, I was diagnosed with malaria. I received treatment for malaria and am fully recovered now,” he said.

This is just one example of the power of community-led efforts to find and diagnose every case and to encourage treatment completion among patients diagnosed with P. vivax as well as P. falciparum malaria.

Using local language and knowledge of local context and cultural norms, community-based health workers can deliver information, prevention products and, where allowed, rapid point-of-care testing for malaria together with referral to nearby health facilities for treatment to communities in the most remote, forested and border areas of the Greater Mekong Subregion.