Malaria burden in the GMS is increasingly concentrated along borders and in forested areas. Civil Society Organisations (CSOs) have been complementing the activities of National Malaria Programs (NMPs) and have played a crucial role in malaria control and elimination in the GMS, especially in providing services to remote and hard-to-reach communities. CSOs have built unique relationships of trust with affected communities, including mobile and migrant populations, illegal workers and marginalized groups, allowing them to access essential health services.
The APMEN Secretariat organized an APMENxChange webinar on 15 June 2020 to highlight the critical role of frontline malaria service providers under CSO projects in ensuring continuity of malaria interventions to at-risk communities during the COVID-19 pandemic.
The webinar titled ‘New challenges, Existing networks: Civil Society experiences in the GMS during COVID-19’ showcased the vital role that CSO networks are playing in sustaining malaria activities, while also repurposing them to better respond to challenges presented by COVID-19. The webinar also looked at how CSOs can support and be engaged in health system strengthening during a pandemic. Ms. Lorina McAdam was the moderator for the webinar and facilitated the panel discussion as well as the interactive Q&A session at the end.
Mr. Shreehari Acharya, Project Manager of the Regional Malaria CSO Platform, GMS at the American Refugee Committee introduced the Regional CSO Platform which covers around 50 CSOs in GMS and includes 33,000 volunteers working under the CSO projects. He presented an overview of the challenges with implementation of CSO activities in the community during Covid-19, such as lack of information around COVID-19, limited protective gear and hand sanitizers for frontline workers, fear and anxiety around providing services especially for fever cases. Shree also highlighted challenges associated with vector control as LLIN mass distribution campaigns and health education sessions could not be conducted during this period. Further, border restrictions in place meant that CSOs could not conduct border malaria services and this resulted in a decrease in number of tests and positive cases. The pandemic has also had an impact on surveillance and M&E as monitoring and data collection, volunteer meetings and regular reporting have all been affected.
Mr. Louis Da Gama, CSO Representative and Executive Member at the RAI RSC and Advisor to the Regional Malaria CSO Platform, GMS shared information about the CSOs’ contribution to national malaria control and elimination strategies during the time of COVID-19. Louis highlighted the fact that CSOs in the regional platform are a very diverse group of organizations who cover different types of healthcare providers including private GPs, doctors, pharmacies. They help to support the NMCPs in reaching the very remote, difficult and hard to reach communities. CSOs are adjusting and adapting strategies and approaches to maintain key interventions and reach the at-risk communities by increasing integration with other diseases. The integration in service delivery in a context like Myanmar has allowed the CSOs to support fever screening for referral as well as psychological counselling during the period of lockdown. There are important lessons from other health programs such as HIV and immunization campaigns around door to door provision of services. The distribution of LLINs could be changed from a mass distribution campaign to door to door distribution, depending on the local context.
There is huge trust between CSOs and community members and the close connection helps CSOs overcome significant social, cultural and language barriers. CSOs are monitoring and collecting data through technology using social media and apps. The CSOs have appreciated the flexibility provided by donors like the Global Fund to reprogram resources for procurement of protective equipment and hand sanitizers. The Regional CSO Platform is organizing regular weekly calls to ensure that CSOs are maintaining malaria interventions during this challenging time.
Dr. Hnin Su Su Khin, Operations Director, Medical Action Myanmar, discussed their experience with maintaining malaria services amid COVID-19. She briefly presented the country malaria situation and highlighted the geographical distribution of malaria in Myanmar with one-fourth of the total positives reported from Paletwa township (one out of 330 townships in the country). She emphasised the critical role of CSOs in Myanmar by sharing data on the caseloads of CSOs compared with that of the national program. CSO providers who are about one-third of total volunteers tested half of total tests done in Myanmar but found more than two third of total positives. Ma Su also presented that the frontline staff and providers are assisting the respective health authorities in fever clinics and supporting the township COVID response teams. She highlighted how MAM is adjusting the strategies and developing SOPs based on this challenging situation.
Dr. Eisa Hamid, Regional Senior Programme, M&E and Health Systems Specialist, Principal Recipient for Global Fund, UNOPS Asia Region explored the role of CSOs and their providers in Malaria and Health System Strengthening. Eisa outlined the WHO definition of a health system and the critical role that CSOs play in health system strengthening across the 6 building blocks of service delivery, workforce, information systems, financing, leadership and commodity supply chains. He emphasized that the health system is a pluralistic system that acknowledged the importance of public and private sector. CSOs’ roles in knowledge sharing, potential task shifting, contributing to surveillance, disease integration, advocating for prioritization of different diseases and representing neglected populations will lead to greater sustainability of the health system.
The webinar was recorded and uploaded in the YouTube channel.