Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Malar J. 2021 Mar 6;20(1):137. doi: 10.1186/s12936-021-03673-7.
Malaria remains a significant public health issue in Indonesia. Most of the endemic areas are in the eastern parts of Indonesia, but there are a few remaining foci of persistent endemic malaria in Java, particularly in Menoreh Hills, a region bordering three districts of two provinces on this island. Despite a commitment to build a partnership to eliminate cross-border malaria, there is a lack of understanding of how this partnership might be translated into an implementable strategic plan. The study aims to provide evidence of how a participatory approach was used to strengthen the cross-border collaboration and stakeholders' capacity to develop a joint strategic, operational, and costing plan for cross-border malaria elimination.
A participatory action research was conducted from January to August 2017, involving participants from the village, district, provincial, and national levels. This study was conducted in seven phases, including document review, focus group discussions (FGDs), planning and costing workshops, and a dissemination meeting. A total of 44 participants from primary health centres (PHC) and 27 representatives of affected villages in three districts, 16 participants from the district and provincial malaria programmes and planning bureaus, and 11 participants from the national level were involved in the processes. Data on priority issues, costing, programme coverage, and administration were collected. Thematic coding and feedback were used for analysis.
Problems identified by stakeholders included low community awareness and participation in malaria prevention, high mobility across three districts, lack of financial and human resources, lack of inter-district coordination, and poor implementation of migration surveillance. Cross-border strategies identified to address malaria were improving cross-border migration surveillance, strengthening the network, governance, and advocacy of malaria control implementation across borders, and developing the malaria information system. A working group composed of the three districts' representatives authorized to decide on cross-border issues will be created.
The participatory approach was applicable in cross-border malaria planning for within-country settings and useful in enhancing stakeholders' capacities as implementers. While done in a participatory way, the joint plan crafted was a non-binding agreement; stakeholders should advocate to ensure adequate funds are poured into mobilizing the programme.
疟疾仍然是印度尼西亚的一个重大公共卫生问题。大多数流行地区位于印度尼西亚东部，但爪哇岛上仍有少数持续存在地方性疟疾的焦点地区，特别是在莫诺勒丘陵地区，该地区与该岛的两个省的三个区接壤。尽管承诺建立合作伙伴关系以消除跨境疟疾，但对于如何将这种伙伴关系转化为可执行的战略计划，缺乏了解。本研究旨在提供证据，说明如何采用参与式方法来加强跨境合作以及利益相关者制定跨境消除疟疾联合战略、运营和成本计划的能力。
参与式行动研究于 2017 年 1 月至 8 月进行，参与者来自村庄、地区、省和国家各级。本研究分七个阶段进行，包括文件审查、焦点小组讨论（FGD）、规划和成本核算研讨会以及传播会议。共有来自三个区的 44 名来自初级卫生中心（PHC）的参与者和 27 名受影响村庄的代表、来自区和省级疟疾规划和规划局的 16 名参与者以及来自国家一级的 11 名参与者参与了该过程。收集了关于优先问题、成本核算、方案覆盖范围和行政管理的数据。使用主题编码和反馈进行分析。
利益相关者确定的问题包括社区对疟疾预防的认识和参与度低、三个区之间的高流动性、缺乏财务和人力资源、缺乏区际协调以及移民监测执行不力。为解决疟疾问题而确定的跨境战略包括加强跨境移民监测、加强边境地区疟疾控制实施的网络、治理和宣传以及开发疟疾信息系统。将成立一个由三个区的代表组成的工作组，授权决定跨境问题。
参与式方法适用于国内跨境疟疾规划，并有助于增强利益相关者作为执行者的能力。虽然是以参与式的方式进行的，但制定的联合计划是一项不具约束力的协议；利益相关者应倡导确保投入足够资金来调动该计划。
