- The refresher course should be provided for VMW at least on year 2 or year 3 of the project implementation.
- Health education should be provided by focusing mainly for the pregnant women and mothers with small children for checking malaria diagnosis without delay when they have fever or suspicion of malaria and follow the treatment course correctly.
- IEC materials related to Early Diagnosis and Treatment should be available and distributed in the 300 VMW villages.
- Regular monitoring with VMW is one of the priority activities that should be conducted regularly to make the project successful.
- The monitoring of the VMWs at the village level should be made by the HC staffs, so some amount of budget should be allocated for this activity.
- The procurement process and other request formalities should be faster to ensure the regular supplies of RDT and anti malarial drugs to all the village malaria workers on time.
- More motivation and encouragement should be offered to VMWs who performed a good job for and actively involved in malaria control activities at their communities.
VI. Overall conclusion
The communication, bad road condition combining with remoteness and low education of the VMW etc. are really the main constraints and great challenges for implementing the VMW project, however, due the strong support from the MOH, CNM and good collaboration with PHDs, HC, local authorities and other stakeholders based in the targeted areas made the project functioning smoothly and receiving satisfactory result.
The VMW project has strong impact and a significant contribution to the reduction of malaria morbidity and mortality in Cambodia, especially in the remote and hard-to-access geographical areas that never had such in the past. The VMW approach has emerged as an effective complementary strategy that plays a key role in bridging the gap and linking the community to the public health service by stimulating community participation, and heralding the shift to sustainable alternatives to malaria control in community, with people’s own efforts in tackling their malaria problems.
During these 3 years of the VMW project's implementation, CNM has gained a lot of satisfactory achievements. Through the VMW networks in the remote and hyperendemic areas in the 7 targeted provinces covered more than 140,000 populations at risk, nearly 150,000 villagers used the service and nearly 90,000 of them were malaria positive and received the treatment from VMWs based in the villages.
The expansion of the VMW network in the forthcoming future will contribute to a better malaria control since the malaria coverage areas are broader than before, especially the data collection more accurate. So the planning and other need estimation will be more precise according to the well defined population at risk define to malaria.