Digging for care-seeking behaviour among gold miners in the Guyana hinterland: a qualitative doer non-doer analysis of social and behavioural motivations for malaria testing and treatment.


Journal

Malaria journal
ISSN: 1475-2875
Titre abrégé: Malar J
Pays: England
ID NLM: 101139802

Informations de publication

Date de publication:
06 Jul 2020
Historique:
received: 16 09 2019
accepted: 17 06 2020
entrez: 8 7 2020
pubmed: 8 7 2020
medline: 3 3 2021
Statut: epublish

Résumé

Although Guyana has made significant progress toward malaria control, limited access to malaria testing and treatment services threatens those gains. Mining activities create breeding environments for mosquitoes, and the migrant and mobile mining populations are hard to reach with information and services. The Ministry of Public Health (MoPH) has trained volunteers to test and treat malaria cases in remote regions. However, it remains unclear how miners perceive these testers, the services they provide, or what their malaria care-seeking behaviour is in general. To better address these challenges, Breakthrough ACTION Guyana and MoPH conducted qualitative research from October to November 2018 in Regions 7 and 8 in Guyana. A total of 109 individuals, 70 miners, 17 other mining camp staff, and 22 other key stakeholders (e.g. community health workers, pharmacists, and regional leadership), participated in semi-structured interviews and focus group discussions. Results were derived using a framework analysis, with an adjusted doer and non-doer analysis, and organized using the integrated behaviour framework. Miners sought MoPH-approved services because of close geographic proximity to testing services, a preference for public service treatment, and a desire to correctly diagnose and cure malaria rather than just treat its symptoms. Those who chose to initiate self-treatment-using unregulated medications from the private and informal sector-did so out of convenience and the belief that self-treatment had worked before. Miners who completed the full MoPH-approved treatment understood the need to complete the treatment, while those who prematurely stopped treatment did so because of medication side effects and a desire to feel better as soon as possible. Reasons why miners do and do not pursue malaria testing and treatment services are diverse. These results can inform better MoPH programming and new solutions to improve malaria outcomes in Guyana.

Sections du résumé

BACKGROUND BACKGROUND
Although Guyana has made significant progress toward malaria control, limited access to malaria testing and treatment services threatens those gains. Mining activities create breeding environments for mosquitoes, and the migrant and mobile mining populations are hard to reach with information and services. The Ministry of Public Health (MoPH) has trained volunteers to test and treat malaria cases in remote regions. However, it remains unclear how miners perceive these testers, the services they provide, or what their malaria care-seeking behaviour is in general. To better address these challenges, Breakthrough ACTION Guyana and MoPH conducted qualitative research from October to November 2018 in Regions 7 and 8 in Guyana.
METHODS METHODS
A total of 109 individuals, 70 miners, 17 other mining camp staff, and 22 other key stakeholders (e.g. community health workers, pharmacists, and regional leadership), participated in semi-structured interviews and focus group discussions. Results were derived using a framework analysis, with an adjusted doer and non-doer analysis, and organized using the integrated behaviour framework.
RESULTS RESULTS
Miners sought MoPH-approved services because of close geographic proximity to testing services, a preference for public service treatment, and a desire to correctly diagnose and cure malaria rather than just treat its symptoms. Those who chose to initiate self-treatment-using unregulated medications from the private and informal sector-did so out of convenience and the belief that self-treatment had worked before. Miners who completed the full MoPH-approved treatment understood the need to complete the treatment, while those who prematurely stopped treatment did so because of medication side effects and a desire to feel better as soon as possible.
CONCLUSION CONCLUSIONS
Reasons why miners do and do not pursue malaria testing and treatment services are diverse. These results can inform better MoPH programming and new solutions to improve malaria outcomes in Guyana.

Identifiants

pubmed: 32631345
doi: 10.1186/s12936-020-03289-3
pii: 10.1186/s12936-020-03289-3
pmc: PMC7336500
doi:

Substances chimiques

Gold 7440-57-5

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

235

Subventions

Organisme : United States Agency for International Development (US)
ID : #AID-OAA-A-17-00017

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Auteurs

Shirley D Yan (SD)

Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, USA. syan8@alumni.jh.edu.

Jennifer Orkis (J)

Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, USA.

Saifra Khan Sohail (S)

Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, USA.

Sean Wilson (S)

Breakthrough ACTION Guyana, XX Barrack St., Georgetown, Guyana.

TrishAnn Davis (T)

Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, USA.

J Douglas Storey (JD)

Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, USA.

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Classifications MeSH