TY - JOUR
T1 - Digging for care-seeking behaviour among gold miners in the Guyana hinterland
T2 - a qualitative doer non-doer analysis of social and behavioural motivations for malaria testing and treatment
AU - Yan, Shirley D.
AU - Orkis, Jennifer
AU - Khan Sohail, Saifra
AU - Wilson, Sean
AU - Davis, Trish Ann
AU - Storey, J. Douglas
N1 - Funding Information:
This work is made possible by the support of the American people through the United States Agency for International Development under the Break-through ACTION Cooperative Agreement #AID-OAA-A-17-00017. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2020 The Author(s).
PY - 2020/7/6
Y1 - 2020/7/6
N2 - 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: 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: 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: 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.
AB - 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: 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: 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: 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.
KW - Care-seeking
KW - Gold miner
KW - Guyana
KW - Malaria
KW - Rapid diagnostic tests
KW - Social behaviour change
UR - http://www.scopus.com/inward/record.url?scp=85087671504&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85087671504&partnerID=8YFLogxK
U2 - 10.1186/s12936-020-03289-3
DO - 10.1186/s12936-020-03289-3
M3 - Article
C2 - 32631345
AN - SCOPUS:85087671504
SN - 1475-2875
VL - 19
JO - Malaria journal
JF - Malaria journal
IS - 1
M1 - s12936
ER -