Impact of a social and behavior change campaign and volunteer malaria tester program on malaria care seeking among gold miners in Guyana

Between 2000 and 2019, malaria cases witnessed a global decline. Recent WHO data indicates a reversal of these gains, threatening the goal to eliminate malaria by 2030. In Guyana, malaria is concentrated in remote regions and among itinerant gold miners who have limited access to malaria health services and will thus often self-medicate or delay care. The government implemented a volunteer malaria tester (VMT) program to increase access to malaria testing and treatment in mining communities. Social and behavior change (SBC) interventions targeting psychosocial determinants of malaria-related behaviors complement this program. The “Lil Mosquito, Big Problem” (LMBP) campaign promotes malaria prevention, testing, and treatment behaviors among miners. This campaign, designed and implemented through a participatory human-centered design process, used the ideation model as its conceptual framework to address knowledge, attitudes, beliefs, and social norms to influence malaria-related behaviors. Surveys conducted in 2019 and 2022 among gold miners in regions 7 and 8 showed increased knowledge and improved psychosocial determinants associated with malaria prevention and treatment. Exposure to the combined VMT and LMBP interventions was associated with significantly higher levels of prompt care-seeking. Interventions should consider attitudes and perceptions and address descriptive norms and the benefits of prompt care-seeking and treatment adherence. Changes in the mining population and economic hardships impact these results. Theory-driven programs systematically designed and implemented through stakeholder involvement and engagement are practical and applicable to similar settings and SBC interventions on other global health issues.