Readiness of malaria elimination in community and health facility of Mannaung Township, Rakhine State, Myanmar in 2022: a mixed-methods study

Background: Myanmar aims to eliminate Plasmodium falciparum malaria by 2025 and all human strains by 2030. In 2018, three townships including Mannaung township in Rakhine State were chosen for elimination pilot projects. The readiness assessment of community health-seeking behaviour and healthcare services of a malaria surveillance system for malaria elimination was conducted in Mannaung township. Methods: In December 2022, a mixed-methods survey interviewed 400 villagers regarding health-seeking behaviour and in-depth interviews (IDI) with Healthcare Providers (HCPs) from eight Health Centers and three hospitals for healthcare services of surveillance systems for malaria elimination. Results: Of 400 households, 154 (38.5%) had at least one family member contracting fever in the last 3 months. Among the 686 members contacted, 220 (32.1%) had a fever within the 3 months. Of these reported fever, 70 respondents (31.8%) were tested with RDT of which 51 (72.9%) were tested within 24 hours. Three main themes emerged from qualitative data analysis: experience of malaria prevention and control activities, malaria case-based response activities and suggestions to improve malaria surveillance. Although most of the HCPs expressed their understanding of testing criteria for malaria elimination, some had a knowledge gap in malaria elimination response activities. The HCPs received malaria elimination training in 2019, but they suggested providing malaria elimination-related training annually. Conclusions: The readiness assessment revealed delayed health-seeking behaviour in malaria thus awareness raising within the community should be provided. The HCPs need to enhance their ability to conduct surveillance activities for malaria elimination.