{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:28:51Z","timestamp":1778977731435,"version":"3.51.4"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001778","name":"Deakin University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001778","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Australian National Health and Medical Research Council"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Malaria volunteers have contributed significantly to malaria control achieving a reduction of annual parasite incidence to pre-elimination levels in several townships across Myanmar. However, the volunteers\u2019 role is changing as Myanmar transitions from a malaria control to elimination programme and towards the goal of universal health coverage. The aim of the study is to explore the perspectives of community leaders, members and malaria volunteers in South-East Myanmar on community-delivered models to inform an optimal design that targets malaria elimination in the context of primary health care in Myanmar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Qualitative methods including focus group discussions (FGDs) with community members and current or ex-malaria volunteers, and participatory workshops with community leaders were conducted. All data collection tools were pilot tested with similar participants. The FGDs were stratified into male and female participants in consideration of diverse gender roles among the ethnic groups of Myanmar. Data saturation was the key cut-off point to cease recruitment of participants. Inductive thematic analysis was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Community members were willing to be tested for malaria because they were concerned about the consequences of malaria although they were aware that malaria prevalence is low in their villages. Malaria volunteers were the main service providers for malaria and other infectious diseases in the community. Apart from malaria, the community identified common health problems such as the flu (fever, sneezing and coughing), diarrhoea, skin infections and tuberculosis as priority diseases in this order. Incorporating preventive, and whenever possible curative, services for those diseases into the current malaria volunteer model was recommended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and conclusion<\/jats:title><jats:p>There was a gap between the communities\u2019 expectations of health services and the health services currently being delivered by volunteers in the community that highlights the need for reassessment and reform of the volunteer model in the changing context. An evidence-based, community preferred, pragmatic community-delivered integrated model should be constructed based on the context of malaria elimination and progressing towards universal health coverage in Myanmar.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12936-020-03555-4","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T21:03:31Z","timestamp":1609967011000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Community demand for comprehensive primary health care from malaria volunteers in South-East Myanmar: a qualitative study"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1378-9405","authenticated-orcid":false,"family":"Win Han Oo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Hoban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Gold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Kyu Kyu Than","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Thazin La","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Aung Thi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freya J. I.","family":"Fowkes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,6]]},"reference":[{"key":"3555_CR1","volume-title":"World Malaria Report 2017","author":"WHO","year":"2017","unstructured":"WHO. World Malaria Report 2017. Geneva: World Health Organization; 2017."},{"key":"3555_CR2","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1186\/s12936-019-2900-1","volume":"18","author":"WH Oo","year":"2019","unstructured":"Oo WH, Gold L, Moore K, Agius PA, Fowkes FJI. The impact of community-delivered models of malaria control and elimination: a systematic review. Malar J. 2019;18:269.","journal-title":"Malar J."},{"key":"3555_CR3","doi-asserted-by":"publisher","first-page":"244","DOI":"10.2471\/BLT.12.109660","volume":"91","author":"GC McCord","year":"2013","unstructured":"McCord GC, Liu A, Singh P. Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions. Bull World Health Organization. 2013;91:244\u201353.","journal-title":"Bull World Health Organization"},{"key":"3555_CR4","first-page":"020401","volume":"4","author":"K Rasanathan","year":"2014","unstructured":"Rasanathan K, Muniz M, Bakshi S, Kumar M, Solano A, Kariuki W, et al. Community case management of childhood illness in sub-Saharan Africa\u2014findings from a cross-sectional survey on policy and implementation. J Global Health. 2014;4:020401.","journal-title":"J Global Health"},{"key":"3555_CR5","first-page":"481","volume":"88","author":"The CDI Study Group","year":"2009","unstructured":"The CDI Study Group. Community-directed interventions for priority health problems in Africa: results of a multicountry study. Bull World Health Organ. 2009;88:481\u2013560.","journal-title":"Bull World Health Organ"},{"key":"3555_CR6","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12913-017-2031-8","volume":"17","author":"M Sekhon","year":"2017","unstructured":"Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017;17:88.","journal-title":"BMC Health Serv Res"},{"key":"3555_CR7","unstructured":"Dom\u00ednguez G. Commitment to eradicate malaria 'a major victory for health diplomacy'. Health, DW-Asia; 2014. http:\/\/www.dw.com\/en\/commitment-to-eradicate-malaria-a-major-victory-for-health-diplomacy\/a-18068883."},{"key":"3555_CR8","unstructured":"WHO. Countries of the Greater Mekong are stepping up to end malaria. WHO\u2019s Mekong Malaria Elimination Programme. 2018. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/276213\/WHO-CDS-GMP-MME-2018.03-eng.pdf."},{"key":"3555_CR9","doi-asserted-by":"crossref","unstructured":"Ohnmar, Tun M, San S, Than W, Chongsuvivatwong V. Effects of malaria volunteer training on coverage and timeliness of diagnosis: a cluster randomized controlled trial in Myanmar. Malar J. 2012;11:309.","DOI":"10.1186\/1475-2875-11-309"},{"key":"3555_CR10","unstructured":"Myanmar National Malaria Control Programme. National Strategic Plan for Intensifying Malaria Control and Accelerating Progress towards Malaria Elimination 2016\u20132020. Nay Pyi Taw: Department of Public Health, Ministry of Health and Sports, The Republic of the Union of Myanmar; 2017"},{"key":"3555_CR11","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12936-016-1102-3","volume":"15","author":"SS Kyaw","year":"2016","unstructured":"Kyaw SS, Drake T, Thi A, Kyaw MP, Hlaing T, Smithuis FM, et al. Malaria community health workers in Myanmar: a cost analysis. Malar J. 2016;15:41.","journal-title":"Malar J"},{"key":"3555_CR12","unstructured":"Myanmar National Malaria Control Programme. National Plan for malaria elimination in Myanmar (2016\u20132030). Department of Public Health, Ministry of Health and Sports, The Republic of the Union of Myanmar; 2017."},{"key":"3555_CR13","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s41182-018-0110-0","volume":"46","author":"NYY Linn","year":"2018","unstructured":"Linn NYY, Tripathy JP, Maung TM, Saw KK, Maw LYW, Thapa B, et al. How are the village health volunteers deliver malaria testing and treatment services and what are the challenges they are facing? A mixed methods study in Myanmar. Trop Med Health. 2018;46:28.","journal-title":"Trop Med Health."},{"key":"3555_CR14","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12916-018-1172-x","volume":"16","author":"ARD McLean","year":"2018","unstructured":"McLean ARD, Wai HP, Thu AM, Khant ZS, Indrasuta C, Ashley EA, et al. Malaria elimination in remote communities requires integration of malaria control activities into general health care: an observational study and interrupted time series analysis in Myanmar. BMC Med. 2018;16:183.","journal-title":"BMC Med"},{"key":"3555_CR15","unstructured":"Moe Myint Oo. Integrated Community Case Management. Dissemination and Consultation Meeting. (Research dissemination meeting). 2017."},{"key":"3555_CR16","unstructured":"Myanmar Department of Public Health. Integrated Community Malaria Volunteer Manual. Department of Public Health, Ministry of Health and Sports, The Republic of the Union of Myanmar; 2017."},{"key":"3555_CR17","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/s12874-018-0594-7","volume":"18","author":"K Vasileiou","year":"2018","unstructured":"Vasileiou K, Barnett J, Thorpe S, Young T. Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC Med Res Methodol. 2018;18:148.","journal-title":"BMC Med Res Methodol"},{"key":"3555_CR18","unstructured":"Family Health International. Qualitative Research Methods Overview. 2019."},{"key":"3555_CR19","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1177\/1937586715614171","volume":"9","author":"KJ Colorafi","year":"2016","unstructured":"Colorafi KJ, Evans B. Qualitative descriptive methods in health science research. Herd. 2016;9:16\u201325.","journal-title":"Herd"},{"key":"3555_CR20","first-page":"2","volume":"16","author":"VA Lambert","year":"2012","unstructured":"Lambert VA, Lambert CE. Qualitative descriptive research: an acceptable design. Pacific Rim Int J Nurs Res. 2012;16:2.","journal-title":"Pacific Rim Int J Nurs Res"},{"key":"3555_CR21","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s40900-017-0077-8","volume":"3","author":"T de Br\u00fan","year":"2017","unstructured":"de Br\u00fan T, O\u2019Reilly-de Br\u00fan M, Van Weel-Baumgarten E, Burns N, Dowrick C, Lionis C, et al. Using Participatory Learning & Action (PLA) research techniques for inter-stakeholder dialogue in primary healthcare: an analysis of stakeholders\u2019 experiences. Res Involv Engagem. 2017;3:28.","journal-title":"Res Involv Engagem"},{"key":"3555_CR22","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12913-015-1247-8","volume":"16","author":"M O\u2019Reilly-de Br\u00fan","year":"2016","unstructured":"O\u2019Reilly-de Br\u00fan M, de Br\u00fan T, Okonkwo E, Bonsenge-Bokanga J-S, De Almeida Silva MM, Ogbebor F, et al. Using Participatory Learning & Action research to access and engage with \u2018hard to reach\u2019 migrants in primary healthcare research. BMC Health Serv Res. 2016;16:25.","journal-title":"BMC Health Serv Res"},{"key":"3555_CR23","unstructured":"Hansen EC. Successful qualitative health research: a practical introduction. First edn. Allen & Unwin; Crows Nest NSW 2065, Australia. April 2006."},{"key":"3555_CR24","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1111\/j.1753-6405.2007.00141.x","volume":"31","author":"J Green","year":"2007","unstructured":"Green J, Willis K, Hughes E, Small R, Welch N, Gibbs L, et al. Generating best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health. 2007;31:545\u201350.","journal-title":"Aust N Z J Public Health"},{"key":"3555_CR25","unstructured":"Miles MBa, Huberman AM, Salda\u00f1a J. Qualitative data analysis: a methods sourcebook: 3rd Edn.Thousand Oaks, California SAGE Publications, Inc., 2014."},{"key":"3555_CR26","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.1177\/1049732316654870","volume":"26","author":"L Birt","year":"2016","unstructured":"Birt L, Scott S, Cavers D, Campbell C, Walter F. Member checking: a tool to enhance trustworthiness or merely a nod to validation? Qual Health Res. 2016;26:1802\u201311.","journal-title":"Qual Health Res"},{"key":"3555_CR27","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/S1473-3099(18)30046-X","volume":"18","author":"TN Nguyen","year":"2018","unstructured":"Nguyen TN, von Seidlein L, Nguyen TV, Truong PN, Hung SD, Pham HT, et al. The persistence and oscillations of submicroscopic Plasmodium falciparum and Plasmodium vivax infections over time in Vietnam: an open cohort study. Lancet Infect Dis. 2018;18:565\u201372.","journal-title":"Lancet Infect Dis"},{"key":"3555_CR28","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1186\/s12936-018-2476-1","volume":"17","author":"J Sattabongkot","year":"2018","unstructured":"Sattabongkot J, Suansomjit C, Nguitragool W, Sirichaisinthop J, Warit S, Tiensuwan M, et al. Prevalence of asymptomatic Plasmodium infections with sub-microscopic parasite densities in the northwestern border of Thailand: a potential threat to malaria elimination. Malar J. 2018;17:329.","journal-title":"Malar J"},{"key":"3555_CR29","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1038\/s41467-019-09441-1","volume":"10","author":"HC Slater","year":"2019","unstructured":"Slater HC, Ross A, Felger I, Hofmann NE, Robinson L, Cook J, et al. The temporal dynamics and infectiousness of subpatent Plasmodium falciparum infections in relation to parasite density. Nat Commun. 2019;10:1433.","journal-title":"Nat Commun"},{"key":"3555_CR30","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s12936-016-1651-5","volume":"16","author":"I Ghinai","year":"2017","unstructured":"Ghinai I, Cook J, Hla TT, Htet HM, Hall T, Lubis IN, et al. Malaria epidemiology in central Myanmar: identification of a multi-species asymptomatic reservoir of infection. Malar J. 2017;16:16.","journal-title":"Malar J"},{"key":"3555_CR31","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1186\/s12936-016-1284-8","volume":"15","author":"TJ Peto","year":"2016","unstructured":"Peto TJ, Kloprogge SE, Tripura R, Nguon C, Sanann N, Yok S, et al. History of malaria treatment as a predictor of subsequent subclinical parasitaemia: a cross-sectional survey and malaria case records from three villages in Pailin, western Cambodia. Malar J. 2016;15:240.","journal-title":"Malar J"},{"key":"3555_CR32","doi-asserted-by":"publisher","first-page":"e0208912","DOI":"10.1371\/journal.pone.0208912","volume":"13","author":"B Adhikari","year":"2018","unstructured":"Adhikari B, Phommasone K, Pongvongsa T, Soundala X, Koummarasy P, Henriques G, et al. Perceptions of asymptomatic malaria infection and their implications for malaria control and elimination in Laos. PLoS ONE. 2018;13:e0208912.","journal-title":"PLoS ONE"},{"key":"3555_CR33","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.puhe.2016.01.001","volume":"132","author":"RW Batterham","year":"2016","unstructured":"Batterham RW, Hawkins M, Collins PA, Buchbinder R, Osborne RH. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 2016;132:3\u201312.","journal-title":"Public Health"},{"key":"3555_CR34","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/1119-3077.146981","volume":"18","author":"SU Arinze-Onyia","year":"2015","unstructured":"Arinze-Onyia SU, Modebe I, Aguwa EN, Nwobodo E. Assessment of knowledge and factors that may predict willingness to volunteerism: a pilot study of community-directed distributors in Anambra state. Niger J Clin Pract. 2015;18:61\u20137.","journal-title":"Niger J Clin Pract"},{"key":"3555_CR35","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/1478-4491-9-21","volume":"9","author":"PP Chaki","year":"2011","unstructured":"Chaki PP, Dongus S, Fillinger U, Kelly A, Killeen GF. Community-owned resource persons for malaria vector control: enabling factors and challenges in an operational programme in Dar es Salaam, United Republic of Tanzania. Hum Resour Health. 2011;9:21.","journal-title":"Hum Resour Health"},{"issue":"Suppl 5","key":"3555_CR36","doi-asserted-by":"publisher","first-page":"46","DOI":"10.4269\/ajtmh.2012.12-0133","volume":"87","author":"CN Kayemba","year":"2012","unstructured":"Kayemba CN, Sengendo HN, Ssekitooleko J, Kerber K, K\u00e4llander K, Waiswa P, et al. Introduction of newborn care within integrated community case management in Uganda. Am J Trop Med Hyg. 2012;87(Suppl 5):46\u201353.","journal-title":"Am J Trop Med Hyg"},{"key":"3555_CR37","volume-title":"Myanmar National Health Plan 2017\u20132021","author":"Myanmar Ministry of Health and Sports","year":"2016","unstructured":"Myanmar Ministry of Health and Sports. Myanmar National Health Plan 2017\u20132021. Nay Pyi Taw: Department of Public Health, The Republic of the Union of Myanmar; 2016."},{"key":"3555_CR38","unstructured":"WHO, World Bank Group. Monitoring progress towards universal health coverage at country and global levels. Geneva, World Health Organization; 2014 (cited 2019 07.05.2019). https:\/\/www.google.com\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwjLta7ppIjiAhVf6nMBHdyaD70QFjAAegQIAhAC&url=https%3A%2F%2Fwww.who.int%2Firis%2Fbitstream%2F10665%2F112824%2F1%2FWHO_HIS_HIA_14&usg=AOvVaw0WlHk5jAydMZKosDKeF20s."},{"key":"3555_CR39","doi-asserted-by":"publisher","first-page":"e989","DOI":"10.1016\/S2214-109X(18)30318-8","volume":"6","author":"SM Han","year":"2018","unstructured":"Han SM, Rahman MM, Rahman MS, Swe KT, Palmer M, Sakamoto H, et al. Progress towards universal health coverage in Myanmar: a national and subnational assessment. Lancet Global Health. 2018;6:e989\u201397.","journal-title":"Lancet Global Health"},{"key":"3555_CR40","unstructured":"Myanmar Vector Borne Disease Control Programme. Vector Borne Disease Control Programme Annual Report, 2016. Nay Pyi Taw: Department of Public Health, Ministry of Health and Sports, Republic of the Union of Myanmar, 2017."},{"key":"3555_CR41","unstructured":"GMS Malaria CSO Platform. Regional CSO consultation on leveraging the roles of Community Malaria Workers\/Volunteers to eliminate malaria and maximize public health benefits at community level 8\u20139th July 2019, Bangkok, Thailand. Workshop report. Bangkok, Thailand: GMS Malaria CSO Platform; August 2019"}],"container-title":["Malaria Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-020-03555-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12936-020-03555-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-020-03555-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T03:09:05Z","timestamp":1697512145000},"score":1,"resource":{"primary":{"URL":"https:\/\/malariajournal.biomedcentral.com\/articles\/10.1186\/s12936-020-03555-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,6]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3555"],"URL":"https:\/\/doi.org\/10.1186\/s12936-020-03555-4","relation":{},"ISSN":["1475-2875"],"issn-type":[{"value":"1475-2875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,6]]},"assertion":[{"value":"28 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was acknowledged by Myanmar Ministry of Health and Sports (Additional file), and reviewed and approved by: (1) Ethics Review Committee on Medical Research Involving Human Subjects, Department of Medical Research, Myanmar Ministry of Health and Sports (Approval Number-Ethics\/DMR\/2017\/150), (2) The Alfred Human Research Ethics Committee in Melbourne, Australia (Project Number-445\/17) and (3) Deakin University Human Research Ethics Committee, Melbourne Australia (Project Number-2017-328) (Additional file).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19"}}