Despite the impacts of an unforeseen concomitant disaster such as COVID-19, malaria elimination efforts were able to continue because of successful efforts to build trust, relevance, and connection with communities to promote community health malaria workers’ acceptance. With lessons learned from the COVID-19 response, community health workers can be repurposed for broader public health interventions in preparation for future disease outbreaks. Key Findings Malaria Consortium-supported mobile malaria workers (MMWs) and mobile malaria posts reported no disruptions in services, based on comparisons between 2020 and the same month-period from the previous year. The communities trust the MMWs because they are recruited from within their communities and are often known to them personally, they speak the same language and are engaged in the same forest activities. Likewise, the MMWs trust their supervisors because of the clear duty of care displayed to them and the provision of consistent, relevant, and rapid support. A management approach that emphasized trust, relevance, and connection (TRC) made the communities and health service program more resilient to external factors beyond their control and ensured people feel comfortable delivering and using MMW services even during times of uncertainty, such as the COVID-19 pandemic. Key Implications If malaria elimination goals are to be successfully reached, it is vital to continue delivering essential early diagnostic and treatment services even during a time of potential crisis. TRC and flexible programming ensure communities and health services are resilient and less dependent on external factors, making it possible for essential service delivery to continue with minimal disruption. Scaling up the TRC approach to the wider MMW program will assist Cambodia, and potentially other settings, in achieving malaria elimination, regardless of the presence of COVID-19 or other potential extraneous disruptive events. ABSTRACT Cambodia has made impressive progress in reducing malaria trends and, in 2018, reported no malaria-related deaths for the first time. However, the coronavirus disease (COVID-19) pandemic presents a potential challenge to the country’s goal for malaria elimination by 2025. The path toward malaria elimination depends on sustained interventions to prevent rapid resurgence, which can quickly set back any gains achieved. Malaria Consortium supported mobile malaria workers (MMWs) to engage with target communities to build acceptance, trust, and resilience. At the start of the pandemic, Malaria Consortium conducted a COVID-19 risk assessment and quickly developed and implemented a mitigation plan to ensure MMWs were able to continue providing malaria services without putting themselves or their patients at risk. Changes in malaria intervention coverage and community uptake have been monitored to gauge the indirect effects of COVID-19. Comparisons have been made between output indicators reported in 2020 and from the same month-period of the previous year. In general, malaria service intervention coverage and utilization rates did not decline in 2020. Rather, the reported figures show there was a substantial increase in service utilization. Preliminary internal reviews and community meetings show that despite a heightened public risk perception toward COVID-19, malaria testing motivation has been well sustained throughout the pandemic. This may be attributable to proactive program planning and data monitoring and active engagement with the communities and the national authorities to circumvent the indirect effect of COVID-19 on intervention coverage in Cambodia during the pandemic.
【초록키워드】 COVID-19, Treatment, coronavirus disease, Resilience, pandemic, COVID-19 pandemic, diagnostic, risk, Intervention, malaria, Outbreaks, Coverage, Health, management, comparison, Impact, Patient, Factors, death, Community, disease, change, Care, Public health intervention, health worker, Scaling, Support, Risk perception, Health Service, connection, Factor, activities, effort, finding, National, approach, country, Prevent, programming, flexible, recruited, reported, conducted, events, supported, less, indirect effect, reducing, dependent on, promote, increase in, reached, circumvent, sustained, assist, engage, build, 【제목키워드】 COVID-19, crisis,