Last Updated: 12/12/2024
Assessing movement patterns and malaria-associated factors among agricultural migrant workers and the feasibility of implementing new targeted anti-malaria interventions in Amhara region, Ethiopia
Objectives
Five objectives were defined:
- Describe the temporal and spatial population movement within Amhara related to malaria risk.
- Map and update information on basic characteristics of all agricultural farms in Metema and Gende Wuha (Amhara Region), Ethiopia.
- Conduct a landscape analysis of a subset of farms to describe farm operations, malaria risk-related behaviors, and current malaria control strategies, and identify potential malaria prevention and control strategies to be implemented at the farms.
- Assess perspectives and feasibility of potential malaria interventions to be implemented at farms.
- Implement a strategy to clear malaria from returning seasonal migrant workers in their home kebeles and evaluate feasibility and acceptability pre- and post-implementation.
Given that there was substantial prior evidence that the migrant workers were at high risk of becoming infected at the farms and bringing their malaria back to their homes, we focused on several key a priori assumptions. That is, we assumed that the options for reducing the malaria risk and the risk of importation back to their homes included:
- Reducing the risk of transmission at the farms (the source) through enhanced prevention and prompt case management; and/or
- Reducing the risk of importing malaria back to their homes (the possible spread) by:
-Clearing infections prior to their departure for home.
-Clearing infections immediately upon their return home.
Descriptive mixed-methods study using quantitative and qualitative data. The quantitative methods included a cross-sectional farm assessment survey using a standardized questionnaire, and collection of surveillance data on travel history in malaria cases from individual patient logs from the outpatient department (OPD) register book. Qualitative methods employed were key informant interviews (KII), focus group discussions (FGD), and direct observations.
A community strategy to clear malaria from returning seasonal migrant workers was implemented in four kebeles. Upon their return from the farms, workers were referred to the health post or to the surveillance assistant in the area to be tested for malaria and treated if positive. To inform the design of the intervention (how the migrant workers would be identified, who would do the testing and treatment, etc.), FGD and KII were conducted with key community stakeholders prior to implementation. The strategy was then implemented in October 2016, when the migrant workers started to return from the farms. Shortly after implementation, more qualitative work was done to understand the acceptability by the migrant workers and lessons learned during the implementation.
Jan 2016 — Dec 2016
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