A village treatment center for malaria: community response in Sri Lanka

Early diagnosis and treatment of malaria cases is one of the basic elements of the current global malaria control strategy. In order to provide this s ervice to people in rural areas there is a need for new cost-effective appr oaches. To ensure that such new approaches are acceptable to the target com munities, it is important to know the rationale for people's malaria treatm ent-seeking behavior. The present study provides insights into the reasons for people's preferences for different types of healthcare facilities and d escribes variation of these preferences within a rural community in Sri Lan ka. The study reports on the experiences with the establishment of a villag e health facility and its effect on the treatment-seeking behavior of the p opulation. After the introduction of the village treatment center it quickl y took over the role of main provider for diagnosis and treatment of malari a from the government facilities. The treatment center did not improve the response time in seeking treatment for young children, but the delay for ad ults was reduced by 1-2 days. Mothers with small children often preferred t he government facilities since they wanted a more qualified opinion than av ailable from the locally recruited staff of the village treatment center. T he treatment center significantly reduced the stress and discomfort experie nced by the elderly and handicapped segment of the community. The study ind icated that the effective catchment area of a village treatment center will be influenced by the degree of initial support from key individuals in the communities, the selection procedure and training of assistants, and the h istory of the relationships between different villages to be served by the center, The government health services and communities across the dry zone of Sri Lanka could benefit substantially from the establishment of more vil lage treatment centers. To ensure the long-term sustainability of these typ e of facilities it is necessary to assess the feasibility of charging a use r fee and establishing multi-purpose clinics. Government policies and admin istrative procedures will need to be adjusted to make the successful operat ion of village treatment centers possible. (C) 2000 Elsevier Science Ltd. A ll rights reserved.