Matsumoto-Takahashi Emilie Louise Akiko, Tongol-Rivera Pilarita, Villacorte Elena Andino, Angluben Ray Uyaan, Jimba Masamine, Kano Shigeyuki
1Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.
2Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654 Japan.
Trop Med Health. 2018 Jul 4;46:24. doi: 10.1186/s41182-018-0105-x. eCollection 2018.
Microscopists have active roles in bringing malaria diagnosis and treatment closer to households in Palawan, the highest malaria-endemic province in the Philippines. To accelerate the elimination of malaria in Palawan, we performed a study based on the bottom-up approach to provide profound data to strengthen this community-based malaria control from the microscopists' point of view.
We performed a qualitative cross-sectional study in Palawan. Four focus group discussions with 50 microscopists were conducted in Palawan from November 2010 to February 2011. During the discussions, the following open-ended questions were addressed: motivation for applying to be microscopists in the "Past" category; job satisfaction, role, problems, and saddest and happiest experiences working as microscopists in the "Present" category; and willingness towards task shifting in the "Future" category. Data were transcribed and analyzed by framework analysis using the NVivo software program.
The present study innovatively proposed the following strategies: reinforcement strategy (adequate supplies and settings), highly prioritized additional strategies (improving social status of microscopists, issuing a travel budget, and including indigenous populations), regional additional strategies (additional malaria control in the southern region and task shifting in the northern region), and less prioritized additional strategies (employment policy and health checkup).
A bottom-up approach using microscopists' perceptions would be a valuable method to propose practical and effective additional strategies for strengthening community-based malaria control.
在菲律宾疟疾流行程度最高的巴拉望省，显微镜检测人员在使疟疾诊断和治疗更贴近家庭方面发挥着积极作用。为加快巴拉望省的疟疾消除工作，我们开展了一项基于自下而上方法的研究，从显微镜检测人员的角度提供深入数据，以加强这种基于社区的疟疾控制。
我们在巴拉望省进行了一项定性横断面研究。2010年11月至2011年2月期间，在巴拉望省与50名显微镜检测人员进行了四次焦点小组讨论。讨论期间，提出了以下开放式问题：“过去”申请成为显微镜检测人员的动机；“现在”作为显微镜检测人员的工作满意度、角色、问题以及最悲伤和最开心的经历；“未来”对任务转移的意愿。使用NVivo软件程序通过框架分析对数据进行转录和分析。
本研究创新性地提出了以下策略：强化策略（充足的物资和设施）、高度优先的附加策略（提高显微镜检测人员的社会地位、发放差旅预算以及纳入原住民）、区域附加策略（南部地区加强疟疾控制以及北部地区进行任务转移）以及低优先级的附加策略（就业政策和健康检查）。
利用显微镜检测人员的看法采用自下而上的方法，将是为加强基于社区的疟疾控制提出切实有效附加策略的宝贵方法。
