Table 2 Outline of major insights from the Define phase
Theme | Insight | Quote |
|---|---|---|
Risk perception | Malaria is seen as routine and commonplace; it is not considered a major health risk for many communities. | “If you want to prevent malaria—don’t come to the bush.”—Miner |
Malaria knowledge and preventive behaviors | There are many contradictions between what people know about malaria and how they behave. | “Once you have malaria, you always have it.”—Miner |
Adherence and non-adherence to correct treatment | Undesirable medication side effects cause some miners to stop treatment as soon as they feel better, while the need to get back to work and be able to keep working causes other miners to follow the regimen. | “I feeling good, so I stop [taking malaria treatment].”—Miner |
Traditional and self-treatment for malaria | Commonly accepted practical solutions to diagnose and treat malaria, which differ from official recommendations, are often preferred due to convenience and personal experience with these treatments. | “I use herbal treatments for malaria if there is no access to a health facility.”—Miner |
Testing | The role of volunteer testers in providing free malaria testing and treatment services is not fully known, understood, or appreciated by miners and other clients. | “I didn’t realize that testing and treatment is offered for free.”—Miner |
Job motivation | Miners and camp workers often prioritize financial/economic gain over their health concerns. | “Making money is my first priority.”—Camp Manager |
Mining camp environment | Miners and their camp managers have strong and respectful relationships because they need each other to be successful at their jobs. | “During work or at the landing you gotta look out for each other because we’re from the same country.”—Miner |
Health care sources | Health facilities are a desired option for health care services, but people will access other sources, if necessary, due to transportation, time, distance, and cost constraints. | “Best thing is to go to the hospital.”—Camp Manager |
RDT training | The RDT training provided by the MoH is effective; however, testers would like to be trained to provide additional health services. | “I didn’t know how malaria was spread until I sat in on RDT training.”—Tester |
Communication | Health communication and health promotion activities and materials, including radio programs, exist but are undeveloped and underutilized. | “More public awareness is needed about testing in remote areas.”—Radio Broadcaster |
Coordination and communication gaps | A lack of coordination and communication between stakeholder groups reduces the effectiveness of the National Malaria Programme. | “Reporting and feedback mechanisms are lacking between testers and regional teams.”—Tester |