Malaria risk factors and care-seeking behaviour within the private sector among high-risk populations in Vietnam: a qualitative study

• Published in: Malaria Journal
• Main Authors: Ingrid Chen, Huong Ngo Thi Thanh, Andrew Lover, Phung Thi Thao, Tang Viet Luu, Hoang Nghia Thang, Ngo Duc Thang, Josselyn Neukom, Adam Bennett
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2017
• Subjects: Vietnam; Malaria; Care-seeking behavior; Private sector; High-risk population; Migrant and mobile populations; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Kon
• Online Access: https://doi.org/10.1186/s12936-017-2060-0; https://doaj.org/article/e35648c6619c400c93fff529626f73ad

Abstract Background Vietnam has successfully reduced malaria incidence by more than 90% over the past 10 years, and is now preparing for malaria elimination. However, the remaining malaria burden resides in individuals that are hardest to reach, in highly remote areas, where many malaria cases are treated through the informal private sector and are not reported to public health systems. This qualitative study aimed to contextualize and characterize the role of private providers, care-seeking behaviour of individuals at high risk of malaria, as well as risk factors that should be addressed through malaria elimination programmes in Vietnam. Methods Semi-structured qualitative interviews were conducted with 11 key informants in Hanoi, 30 providers, 9 potential patients, and 11 individuals at risk of malaria in Binh Phuoc and Kon Tum provinces. Audio recorded interviews were transcribed and uploaded to Atlas TI™, themes were identified, from which programmatic implications and recommendations were synthesized. Results Qualitative interviews revealed that efforts for malaria elimination in Vietnam should concentrate on reaching highest-risk populations in remote areas as well their care providers, in particular private pharmacies, private clinics, and grocery stores. Among these private providers, diagnosis is currently based on symptoms, leaving unconfirmed cases that are not reported to public health surveillance systems. Among at-risk individuals, knowledge of malaria was limited, and individuals reported not taking full courses of treatment, a practice that threatens selection for drug resistance. Access to insecticide-treated hammock nets, a potentially important preventive measure for settings with outdoor biting Anopheles vectors, was also limited. Conclusions Malaria elimination efforts in Vietnam can be accelerated by targeting improved treatment, diagnosis, and reporting practices to private pharmacies, private clinics, and grocery stores. Programmes should also seek to increase awareness and understanding ...